Use this form to submit information for new students and changes for existing students
		home teachers MusicFun! music honors program events enrollment forms contact us	Payholder / Account Name		*
			e-mail		*
			* required fields
			Student Name
			Birthday		(mm/dd/yyyy) Dexterity Left-Handed Right-handed
			Lesson Day		Sun Mon Tue Wed Thu Fri Sat Lesson Time a.m. p.m.
			Lesson Length		(in minutes) Instructor   Miss Amanda Miss Ashley Miss Chelsea Miss Deidre Miss Jamie Miss Katie Miss Rae Miss Rebekah Miss Terri Mr James
			Date to start lessons		(mm/dd/yyyy)
			Instrument		Instrument Make & Model
			Student's School		Grade>   pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
					What style(s) of music INTEREST THIS STUDENT?
					What style(s) of music are you and this student INTERESTED IN PLAYING?
			Please give a brief summary of this student's experience and ability in the following areas of education. This will help the instructor customize the perfect learning environment !
			Reading ability
			Alphabet knowledge
			Mathematics level
			Physical ability
			Gross motor skills
			Fine motor skills
			Visual learning ability
			Aural learning ability
			Previous lessons		Series used (if applicable)
			Dance / movement experience
			Use this text box to inform The Music Staff Studio Performing Arts Academy of any special needs or concerns, disabilities, and / or medications pertaining to this student
			Special needs / concerns, disabilities, and / or medications		Note: You can also enter "additional comments" in this text box
			The Music Staff Studio Performing Arts Academy has my permission to share this information with the instructor for educational purposes Yes No
			When you click the Submit button a window will open asking you to confirm the information is correct before it is sent to The Music Staff Studio Performing Arts Academy This is not a secure website! Do not enter sensitive information like account numbers in the comments box.