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Please choose the program for which you are starting the enrollment process.

Student Information

Please fill out the following form to begin the registration process.

First Name(Required)

Last Name(Required)

Birth Date(Required)

Age(Required)

Ethnicity (Optional)

School

Grade

Email Address

Family Information

Parent/Guardian 1 Info

First Name

Last Name

Occupation

Employer

Email

Home/Cell Phone

Work Phone

Parent/Guardian 2 Info

First Name

Last Name

Occupation

Employer

Email

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Work Phone

Music Lessons

If yes, list name(s) and instrument(s):

How did you hear about the Preucil School of Music?

Program

Choose the program/s you would like for your child.

Most students start in the Summer or Fall. Few positions open for other terms or during the year. Priority is given to families with children in preschool, lessons or classes at Preucil School who submit a placement form by Nov. 1 of the year preceding the year they wish to enroll. Beginning in February, families who have requested placement for Spring, Summer, or Fall will be contacted in the order of their priority and the date their placement fee was received. When contacted, they will be offered all open spots.

Year

If Yes: Prior teacher/program(Required)

Reason for transfer:(Required)

Dates of study:(Required)

Current Literature:(Required)

Please check all times you are available for lessons

Comments: please include special lesson time circumstances here.

Placement Fee(Required)

Price:

Placement Fee(Required)

Price:

+ Credit Card Processing Fee(Required)

Price: $0.00

Total

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Master Lesson Placement Form

Student Information

Family Information

Parent/Guardian 1 Info

Parent/Guardian 2 Info

Music Lessons

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