CMI ENROLLMENT APPLICATION
Please complete the application to enroll in CMI's summer education program.
Students ranging from age 8-18 will be accepted.
STUDENT INFORMATION
Student's First Name *
Your answer
Student's Last Name *
Your answer
Address *
Your answer
Phone *
Your answer
Email *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Current School
Your answer
Current Grade
Your answer
School District
Your answer
PARENT/GUARDIAN INFORMATION
PARENT/GUARDIAN NAME *
Your answer
PARENT GUARDIAN PHONE *
Your answer
Emergency Contact *
Your answer
Emergency Phone *
Your answer
Would you like to volunteer for the Summer Education Program?
If "Yes" please mark what you can help with.
MUSIC BACKGROUND
Instrument *
What type of musical training have you had? *
How many years have you been studying? *
Your answer
MEDICAL INFORMATION
Does your child require special care or have any disabilities?
If "Yes" please explain
Your answer
Is your child currently taking any prescribed medication?
If "Yes" please list
Your answer
Does your child have any allergies, existing or previous illness?
If "Yes" please describe
Your answer
Has your child been hospitalized in the last 12 months?
If "Yes" please explain
Your answer
FINANCIAL ASSISTANCE APPLICATION
If your student is eligible for financial assistance please fill out the following form
Students Name (response required)
Your answer
Parent/Guardian Name (response required)
Your answer
Parent/Guardian Address (response required)
Your answer
Parent Guardian Phone Number (response required)
Your answer
Email Address (response required)
Your answer
Occupation (response required)
Your answer
Reason for Financial Assistance (response required)
If "Other" please explain
Your answer
Financial Assistance will be awarded based on a combination of talent and financial need with coverage ranging from 75% to 100% of the tuition.
If you have any additional questions regarding financial assistance please ask below.
Your answer
Personal information that you enter will be treated as strictly confidential and will only be used for our internal records. We will not share your information with others without your prior consent.
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