Continuing Student Enrollment Form

If you wish to continue your child’s enrollment in the OBU Preparatory Department, please fill out the following form. Failure to complete this form by May 15 may result in losing your child’s placement for the 2011-2012 school year. You will be contacted at the end of the summer for your child’s lesson/class time.

If you wish to discuss your child’s enrollment, please contact Mrs. Hansford at 878-2319 or 273-2273.
* required fields

*Please check one of the following:
Private Piano
Private Voice
Kindermusik (babies to 18-months)
Kindermusik (2 years old)
Kindermusik (3-5 years old)
Keyboard Concepts (2nd & 3rd grade beginning piano class)
Keyboard Readiness (kindergarten and 1st grade beginning piano class)
Violin
String Ensemble
Cello
Guitar
Other Instrument

*First Name


*Last Name


Address


*City


*Zip


Billing Name and Address (if different from above)


*E-mail Address


*Cell Phone


*Home Phone


Work Phone (adult students)


Mother's Name


Work or Cell Phone


Father's Name


Work or Cell Phone


School


Grade (2011-2012)


*Birthday


*First choice of lesson day and time


*Second choice of lesson day and time


*Third choice of lesson day and time


*Lesson length
30-minute lesson
45-minute lesson

*Days and times to avoid