Composing Musicians Piano And Voice Lessons Application Page

application

Student Application

This information is kept private. Please fill this information out thoroughly and accurately. A complete student record is needed to begin lessons.

Who Referred You?:
Brand Name, Number and Description Of Piano, Digital Piano or Keyboard:
Adults:	Legal First Name (Nickname) Last Name EXAMPLE: Jennifer (Jennie) Smith
Mother:
Father:
Step-Mother:
Step-Father:
Grandmother:
Grandfather:
Female Guardian:
Male Guardian:
Girlfriend/Fiancee:
Boyfriend/Fiance:
Adult Student:
Notes:
* Adult Overseeing Lessons: *
Students:	Legal First Name (Nickname) Last Name EXAMPLE: Bradley (Brad) Smith
Name (Student 1):
Birth Date (Student 1):	(Month/Date/Year)
Age (Student 1):
Grade (Student 1):
ID Number (Student 1):	STU (4 digits)
	Female (Student 1)
	Male (Student 1)
	Piano Lessons (Student 1)
	Voice Lessons (Student 1)
Name (Student 2):
Birth Date (Student 2):	(Month/Date/Year)
Age (Student 2):
Grade (Student 2):
ID Number (Student 2):	STU (4 digits)
	Female (Student 2)
	Male (Student 2)
	Piano Lessons (Student 2)
	Voice Lessons (Student 2)
Name (Student 3):
Birth Date (Student 3):	(Month/Date/Year)
Age (Student 3):
Grade (Student 3):
ID Number (Student 3):	STU (4 digits)
	Female (Student 3)
	Male (Student 3)
	Piano Lessons (Student 3)
	Voice Lessons (Student 3)
Name (Student 4):
Birth Date (Student 4):
Age (Student 4):
Grade (Student 4):
ID Number (Student 4):	STU (4 digits)
	Female (Student 4)
	Male (Student 4)
	Voice Lessons (Student 4)
	Piano Lessons (Student 4)
Contact Information:
Address:
Apartment/Unit #:
City:
State:
Zip Code:	(5 digits)
Home Phone:
Work Phone:
Cell Phone:
e-mail:
History and Goals:
Student 1 ~ List All Music Experience:
Student 1 ~ Music Goals:
Student 1 ~ Starting Level:
Student 2 ~ List All Music Experience:
Student 2 ~ Music Goals:
Student 2 ~ Starting Level:
Student 3 ~ List All Music Experience:
Student 3 ~ Music Goals:
Student 3 ~ Starting Level:
Student 4 ~ List All Music Experience:
Student 4 ~ Music Goals:
Student 4 ~ Starting Level:
Comments:	Enter comments here!
Submit Form:	Upon submitting this form, you will be returned to the home page. Composing Musicians will contact you within 48 hours.

Babysitter Application

Please fill this application out completely. Accepted babysitters will be placed on a mass babysitting e-mail list, to receive a reminder e-mail for each 5-Week-Course, with details on how to sign-up to babysit for specific lessons dates and times. The only commitment is that the babysitter faithfully babysit for the lesson dates and times that the babysitter signs-up for.

First Name:
Last Name:
Street Address:
Apartment/Unit #:
City:
State:
Zip Code:	(5 digits)
Home Phone:
Work Phone:
Cell Phone:
e-mail:
Comments and Questions:	Enter comments here!
Note: A 1099 IRS Tax Form will be filled out by Composing Musicians for all babysitters!	Do you agree? Yes http://www.irs.gov/pub/irs-pdf/f1099msc.pdf http://www.irs.ustreas.gov/pub/irs-pdf/i1099gi.pdf