GENERAL INFORMATION

Name of Parent(s):   

Address:   

City:         State:         Zip: 

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):          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.

Where did you hear about us (hold down the shift or ctrl key to make multiple selections)?  

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STUDENT INFORMATION

Name:  

Age:        D.O.B.:   (MM/DD/YYYY)

Availability for classes – Please give the start and end time each day when you are available for your class. Please provide as much availability as possible!

Please explain the student's prior experience on the instrument and his/her level of ability. This is important for proper matching with other students for the ensemble.

 If you have additional students to register, please submit another form. 

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PAYMENT INFORMATION

Your registration is NOT confirmed until payment is received. Please select your preferred method:

  TO PAY BY CHECK: Check # of your tuition payment

          Mail the payment to: Prestige Music Studios, Inc., RE: RockShop, 46 Village Pointe Drive, Powell, OH 43065

  TO PAY BY CREDIT CARD: Call 888.58.PRESTIGE x704 for the telephone credit card processing center. We accept Visa or MasterCard. Please be sure to include the following in your message: the name on the card, and the spelling, stated slowly and clearly; the credit card number and expiration date; the zip code where your bill or statement is received; and, the V-Code, or the last 3 digits on the back of your card. Please also confirm the amount to be charged to your card. If you have any questions, please contact us and resolve those issues prior to giving us your credit card information. A confirmation will be emailed or mailed to you upon processing your credit card.

Please read the box below and initial here:   

     We do not process this registration and include your availability in the scheduling of the class until payment in full is received. We will notify you the week before the class begins with the day/time of the class. Tuition is non-transferable and non-refundable, unless we are unable to create a class within your availability listed. If your availability changes after you have submitted this form, we are not responsible for those changes; however, please notify us so that we may make every attempt to include you in a class. Please double check your availability for accuracy. Thank you!

Additional comments or questions:

Thank you for submitting your registration! 

Please remember to remit payment in order for your registration to be considered in the scheduling of the RockShop.