Pearson Ranch Band IMIP Student/Parent Application form
Student Name *
Your answer
Name of Parent, Guardian or Sponsor *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Contact Phone Numbers - Primary *
Your answer
Secondary
Your answer
Email address *
Your answer
Student's instrument *
What Band are you in? *
What Lesson Length do you want? *This can be changed at anytime *
Time Preference - Time preferences will be based on first come first serve basis *
Please list any possible time/schedule conflicts to avoid.
Your answer
Do you already have a lesson teacher? If so, who?
Your answer
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