Summer Private Lesson Registration 2019
Welcome!!! This form is a complete registration form for all lessons. This form needs to be filled out for each child/person you are registering.
Email address *
Summer Private Lessons June 1st -July 20th
Private lessons are 30 minutes each and consists of 8 weeks. Payment must be made in full either before or by the first day of the semester, unless a payment plan has been established. Prices are listed in this registration form.

Have any remaining questions or need to make changes to your registration? You can reach us at 626.731.8261 by calling or texting. Texting is often a faster reply. You may also email the Director Dr. Alexander Koops at akoops@apu.edu.

STUDENT'S FIRST NAME *
Your answer
STUDENT'S LAST NAME *
Your answer
BIRTH DATE *
MM
/
DD
/
YYYY
PARENT'S/GARDIAN'S NAME(S) *
Your answer
PRIMARY PHONE NUMBER *
Your answer
SECONDARY PHONE NUMBER
Your answer
EMAIL *very important for receiving information* *
Your answer
ADDRESS *
Your answer
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