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Student Name *

First Name

Last Name

Primary Guardian Name 1 *

First Name

Last Name

Primary Guardian 1 Phone *

(###)

###

####

Primary Guardian Name 2

First Name

Last Name

Primary Guardian 2 Phone

(###)

###

####

Primary Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Best Phone Number *

(###)

###

####

Primary Language

English

Spanish

Other:

Does your family currently or do you expect to qualify for free/reduced lunch?

Yes

No

Maybe

What is your child's ethnicity? *

White

African American or Black

Latino or Hispanic

Decline to answer

Other:

What grade will your child be in during the 2023-24 school year? (Please note priority will be given K-2nd) *

K

1st

2nd

3rd

4th

5th+

What is your child's gender? *

Female

Male

Does your child have previous experience with instruments or musical instruction? * *

Yes

No

Does your child have a documented disability (mental, physical)? *

Yes

No

Does your child have a 504 plan or IEP? *

Yes

No

What tuition does your family qualify for?

$20 (Free Lunch Program)

$138 (Reduced Lunch Program)

$276 (No Free/Reduced Lunch Program)