Biographical Information
Email address *
Student Name
First Name *
Your answer
Middle Name *
Your answer
Last Name *
Your answer
Grade *
Student Instrument
Your answer
Student Instrumental Teacher
Your answer
Student Primary Address & Phone
Street *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Student Cell Phone *
Your answer
Student Accommodations
Does this child have an Individual Education Plan (IEP)? *
Required
Does this child have an 504 Accommodation Plan? *
Please submit the following forms. Please note all forms need to be renewed yearly. https://www.schools.nyc.gov/school-life/health-and-wellness/504-accommodations
Required
Does this child have an allergy? *
Required
Does this child have asthma? *
Required
Contact Information – Parent #1
First Name *
Your answer
Last Name *
Your answer
Home Telephone *
Your answer
Business Telephone
Your answer
Cellular Telephone *
Your answer
Email Address *
Your answer
Address
(If different from student's address.)
Your answer
Contact Information - Parent #2
First Name
Your answer
Last Name
Your answer
Home Telephone
Your answer
Business Telephone
Your answer
Cellular Telephone
Your answer
Address
(If different from student's address.)
Your answer
Email Address
(If different from student's address.)
Your answer
Home Life
Language spoken at home *
(For telephone use)
Your answer
Preferred written language *
(For mail sent home)
Your answer
Preferred method of communication with school: *
Housing Status *
Required
Emergency Contact
Please add a list of all adults who have permission to pick up your child in the event of an emergency. Please include contact information.
Contacts:
Your answer
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