Registration || Santa Barbara Conservatory

Santa Barbara Conservatory of Music Foundation
Registration Form

Student Information

Student Name:

Date of Birth:

Age:

Grade:

School (if applicable):

Gender (optional):

Parent/Guardian Name:

Relationship to Student:

Address:

Phone (Home):

Phone (Cell):

Email:

Name:

Relationship:

Phone:

Preferred Teacher (if any):

Lesson Type:

Private Lessons Group Class Ensemble / Chamber Music

Preferred Days/Times:

How long has the student studied music?

Previous teacher or school (if any):

Does the student read music?

Goals or areas of interest:

Tuition Amount:

Payment Method:

Credit Card Bank Transfer

Payment Plan:

Full Quarter Monthly

I grant permission for photo/video use. I do not grant permission.

Signature:

Date:

I have read and agree to the school policies.

Signature:

Date: