GENERAL INFORMATION

Name You Would Like To Have On The Account: 

Address: 

City:       State:               Zip:      County (not "country"):   

Home Tel with Area Code: (ex: (123) 456-7890)

Work Tel with Area Code: (ex: (123) 456-7890)

Cell with Area Code: (ex: (123) 456-7890)

Fax with Area Code: (ex: (123) 456-7890)

Other Tel with Area Code: (ex: (123) 456-7890)

E-mail address (*required):  IMPORTANT: We will email your invoices to this email address.  Please be sure to add prestigemusicstudios.com to your "safe senders domain" list so the invoices do not go to junk mail.  If you need to receive paper invoices in the mail, there is a $2 per invoice service charge.  If you need this service, please check here.

With whom have you spoken or met regarding lessons?   Choose one... SaraMarie Eichenberger, President/CEO, x801 Elizabeth D. Elliott, Assistant Director, x803

Are you a member of Angie's List, Columbus?     Choose one... Yes No

Where did you hear about the studio?    

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STUDENT INFORMATION

STUDENT 1

Name: 

Age:       D.O.B.:  (MM/DD/YYYY)

Instrument - hold down the shift or ctrl key to make multiple selections:                                

             Brass Instrument (Trumpet, Trombone, etc.) Guitar: Acoustic Guitar: Electric Guitar: Suzuki (suggested for children under 8yo) Percussion (drumset, etc.) Piano: Private, Suzuki (suggested for ages 3-8yo) Piano: Private, Traditional Songwriting Strings, other than violin Studio Program (1-3 hrs weekly of private dance, drama, and/or voice) Theory Violin: Suzuki (suggested for students of all ages) Violin: Traditional Voice Woodwinds (Flute, Clarinet, Sax, Oboe, etc.)

Number of Lessons Per Week:  Choose one... 2x/wk, suggested for ages 3-5 2x/wk 1x/wk

Prior experience on instrument(s):

The suggested lesson length will be assigned to the student.  If you prefer otherwise, please state and explain here:

     Leave blank if suggested lesson length is acceptable.

Where do you prefer to have your lessons?   In home

     If you are a Suzuki student, would you like to participate in our monthly Suzuki group classes? These are highly recommended. Yes No

Will you accept another location if your preference is not available?   Choose one... Yes No

Availability for lessons – Please give the start and end time each day when you are available for lessons.  We offer lessons on the following days and times: Monday - Friday, 9am-9pm; Saturday, 9am-4pm; regular lessons are not scheduled on Sundays

If you have additional students to register, please do so below.  You may register up to 4 students on this form, or submit another form to register more than 4 students.  If you have completed the student information, please continue to the end of the form.

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STUDENT 2

Name:

Age:       D.O.B.: (MM/DD/YYYY)

Instrument - hold down the shift or ctrl key to make multiple selections:                                

     Brass Instrument (Trumpet, Trombone, etc.) Guitar: Acoustic Guitar: Electric Guitar: Suzuki (suggested for children under 8yo) Percussion (drumset, etc.) Piano: Private, Suzuki (suggested for ages 3-8yo) Piano: Private, Traditional Songwriting Strings, other than violin Studio Program (1-3 hrs weekly of private dance, drama, and/or voice) Theory Violin: Suzuki (suggested for students of all ages) Violin: Traditional Voice Woodwinds (Flute, Clarinet, Sax, Oboe, etc.)

Number of Lessons Per Week:  Choose one... 2x/wk, suggested for ages 3-5 2x/wk 1x/wk

Prior experience on instrument(s):

The suggested lesson length will be assigned to the student.  If you prefer otherwise, please state and explain here:

     Leave blank if suggested lesson length is acceptable.

Where do you prefer to have your lessons?   In home

     If you are a Suzuki student, would you like to participate in our monthly Suzuki group classes? These are highly recommended. Yes No

Will you accept another location if your preference is not available?   Choose one... Yes No

Availability for lessons – Please give the start and end time each day when you are available for lessons.  We offer lessons on the following days and times: Monday - Friday, 9am-9pm; Saturday, 9am-4pm; regular lessons are not scheduled on Sundays

If you have additional students to register, please do so below.  You may register up to 4 students on this form, or submit another form to register more than 4 students.  If you have completed the student information, please continue to the end of the form.

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STUDENT 3

Name:

Age:       D.O.B.: (MM/DD/YYYY)

Instrument - hold down the shift or ctrl key to make multiple selections:                                

      Brass Instrument (Trumpet, Trombone, etc.) Guitar: Acoustic Guitar: Electric Guitar: Suzuki (suggested for children under 8yo) Percussion (drumset, etc.) Piano: Private, Suzuki (suggested for ages 3-8yo) Piano: Private, Traditional Songwriting Strings, other than violin Studio Program (1-3 hrs weekly of private dance, drama, and/or voice) Theory Violin: Suzuki (suggested for students of all ages) Violin: Traditional Voice Woodwinds (Flute, Clarinet, Sax, Oboe, etc.)

Number of Lessons Per Week:  Choose one... 2x/wk, suggested for ages 3-5 2x/wk 1x/wk

Prior experience on instrument(s):

The suggested lesson length will be assigned to the student.  If you prefer otherwise, please state and explain here:

     Leave blank if suggested lesson length is acceptable.

Where do you prefer to have your lessons?   In home

     If you are a Suzuki student, would you like to participate in our monthly Suzuki group classes? These are highly recommended. Yes No

Will you accept another location if your preference is not available?   Choose one... Yes No

Availability for lessons – Please give the start and end time each day when you are available for lessons.  We offer lessons on the following days and times: Monday - Friday, 9am-9pm; Saturday, 9am-4pm; regular lessons are not scheduled on Sundays

If you have additional students to register, please do so below.  You may register up to 4 students on this form, or submit another form to register more than 4 students.  If you have completed the student information, please continue to the end of the form.

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STUDENT 4

Name:

Age:       D.O.B.: (MM/DD/YYYY)

Instrument - hold down the shift or ctrl key to make multiple selections:                                

      Brass Instrument (Trumpet, Trombone, etc.) Guitar: Acoustic Guitar: Electric Guitar: Suzuki (suggested for children under 8yo) Percussion (drumset, etc.) Piano: Private, Suzuki (suggested for ages 3-8yo) Piano: Private, Traditional Pre-Modeling/Etiquette/Polishing Coaching or Summer Camp Songwriting Strings, other than violin Studio Program (1-3 hrs weekly of private dance, drama, and/or voice) Theory Violin: Suzuki (suggested for students of all ages) Violin: Traditional Voice Woodwinds (Flute, Clarinet, Sax, Oboe, etc.)

Number of Lessons Per Week:  Choose one... 2x/wk, suggested for ages 3-5 2x/wk 1x/wk

Prior experience on instrument(s):

The suggested lesson length will be assigned to the student.  If you prefer otherwise, please state and explain here:

     Leave blank if suggested lesson length is acceptable.

Where do you prefer to have your lessons?   In home

     If you are a Suzuki student, would you like to participate in our monthly Suzuki group classes? These are highly recommended. Yes No

Will you accept another location if your preference is not available?   Choose one... Yes No

Availability for lessons – Please give the start and end time each day when you are available for lessons.  We offer lessons on the following days and times: Monday - Friday, 9am-9pm; Saturday, 9am-4pm; regular lessons are not scheduled on Sundays

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If you have not yet met with the Director or Assistant Director at the studio, in person, to discuss lessons, please list your general availability here.  For this meeting: please schedule a day and time; parents only, please, whenever possible; and, if you would like to bring your child to the studio, we prefer that you schedule a second appointment.  Should you need to bring your child, please bring an activity.  This appointment should last 15-45 minutes. We schedule these appointments on weekdays only, until 9am-9pm - Saturdays and Sundays are not available for appointments with a manager.

Do you have any coupons or specials that encouraged you to register today?  If so, please describe here which one you have by using the appropriate coupon code.  Coupons are not accepted after this registration form has been submitted. If you wish to use a coupon, please complete the Specials Agreement and return it with your registration payment and before lessons begin. 

Please type your initials here to confirm that you have received, read, and understand Prestige Music Studios, Inc.'s policies regarding all operations including attendance, billing, what we offer, our orientation and welcome program, our year, lesson lengths, tuition, service area and extended service area, Suzuki group lessons, canceling and rescheduling lessons, studio closures, student injury, recitals and performance classes, books and music, and the "triple play program."