2018-2019 Leavitt Piano Studio Registration
Parent Name *
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Student Name(s) *
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Age of Student(s) *
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Student Birthday(s) *
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School District *
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Grade(s) *
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Mailing Address *
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Phone Number(s) *
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E-mail(s) *
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Preferred lesson time length *
Private lessons will be scheduled during afternoon and evening hours, Monday-Friday. Please list your 1st, 2nd, and 3rd choices for lesson times below (example: Monday after 4:00). The registration fee of $80 per student is due July 1, 2018. Priority scheduling will be given to students who have registered for summer lessons. *
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Studio Policy Agreement *
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