Young Musician Institute Inquiry Sheet

Name:
Name of Student:
Age of Student:
Address:
City:
State:
Zip Code:
Home Phone:
Business Phone:
Best Time To Call:
Email Address:
Instrument of Interest:
WHEN WOULD YOU LIKE LESSONS?
Class Time Preference: Weekday Evening Saturday
Camp Interest? Yes No
FOR STUDENTS AGES 6 MONTHS - 5 YEARS (click one)
Kindermusik: Villages Our Time Imagine That Young Musician Not Applicable