Amison Institute of Music
Student registration
Student Name *
First only
Student Name *
Last only
Physical Address *
Apartment Number or NONE
Street number *
Street Name *
City *
State *
Zip Code *
Student email or NONE *
Student phone number or NONE *
Age *
Grade *
Current School *
School attending next year *
Instrument *
Year's played *
Method studied *
Past private teacher or NONE *
Gender *
Guardian *
Primary
Full address *
Email address *
Phone number *
Guardian *
Secondary
Full address *
Email address *
Phone number *
Emergency contact *
Full address
Email address *
Phone number *
Relationship *
Other instruments or NONE *
Currently studing and length
Other Instruments or NONE *
Previously studied and length
After school activities or NONE *
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