Student Registration Form 2021-2022

  • Student Information

    Please select all instruments that the student is interested in studying.
  • MM slash DD slash YYYY
  • If you are an adult student, please enter "Adult"
  • Student Availability and Learning Model

    Please choose the days and times that your child is available for lessons.
  • Please select all that apply. If you would like to offer more specific availability, please do so below.
  • Of the days selected above, please provide a time range that you or your child is available for lessons. For example : 2:30-5pm.
    Please select your preferred learning model for the Fall semester.
  • Parent 1 Information

  • Parent 2 Information

  • Policies and Permissions

    I do not give Michelle Lavin Music permission to take photographs of me or my child to be used in brochures, web sites, posters, advertisements, and social media.
  • Please check all that apply
  • Registration Deposit

    A non-refundable deposit of $100.00 is required to register for lessons. YOUR LESSON SPOT IS NOT SECURE UNLESS YOU HAVE REGISTERED AND SUBMITTED YOUR DEPOSIT. The deposit will be deducted from the student's first semester tuition.
  • Price: