EMU Community Music Academy Fall 2018 Keyboard Games Class Registration
10-week class session runs Mon Oct 8-Mon Dec 10, 2018 (5:30-6:15pm)
Registering is a two-step process:
1) Select the course or courses from the list for which you wish to register and complete the form below. (Please submit separate forms for each student.)
2) Bring cash or a check written out to "EMU" to your first class. Registration is not complete until payment has been received.
Which class would you like to register for?
Ten 45-minute Keyboard Games Classes: $150.00
Do you qualify for a discount?
Multiple Siblings (Receive $25 off each registration fee if you enroll siblings in the same class)
Student Name (first & last)
History of musical experiences:
Does the student have any special circumstances of which the EMU CMA staff should be made aware?
CONTACT INFORMATION FOR PARENTS/GUARDIANS
Parent/Guardian 1 Name (first & last)
Parent/Guardian 1 Email Address
Parent/Guardian 1 Mailing Address (street, city, state, zip)
Parent/Guardian 1 Phone Number
Parent/Guardian 1 Alternate Phone (if applicable)
Parent/Guardian 2 Name (first & last)
Parent/Guardian 2 Email Address
Parent/Guardian 2 Phone
Referral Information: How did you hear about us?
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service