Phone: 469-661-8116         Email: Lessons@MindaMusicStore.com

Online Registration Form

Please fill out the following registration form. Time slots are limited, so please register early! We will do our best to accommodate your first preference.

Student's Information
  * Student's Name:
* Your Name:
* Birthday:
(as mm/dd/yyyy)
* Age:
School:
Grade:
Extracurricular Activities:
Previous Music Experience:
  years
* Medical condition(s) or allergies (including food allergies):
Parent's Information
  * Parent(s) Names:
  * Primary Phone Number:
  * Cell Phone Number:
  * Email Address:
  * Address:
  * City:
  * Zip:
Billing Information (if different than above)
Billing Address:
Billing City:
Billing Zip:
Emergency Contact
  * Name:
  * Phone:
Lesson Information
* I am registering for:
Lessons   Summer MusArt Camp   CHIMPS
Rock N Roll Summer Program   Teen Workshops   Adult Summer Program
Adult Workshops   Other
* Preferred Start Date:
(enter as mm/dd/yyyy)
* Instrument Choice:
Piano
Guitar
Violin
Harp
Ukulele
Voice
Other
With emphasis on
(select one):







Lesson Type
Drop-In Lessons:
30 min @ $40
45 min @ $60
60 min @ $80
4 Private lessons/month :
30 min @ $104
45 min @ $156
60 min @ $200
3 Private & 1 Group/month:
30 min @ $96
45 min @ $132
60 min @ $168
Group Lessons:
$25 each
Group Lesson Type:
None Beginner Intermediate Advanced Other
Private Lesson Time/Day Preference:

MindaMusic Studio is open: Monday-Friday 12-8pm, Saturday 12-4pm & Sunday 3pm-5:30pm

* 1st Preference:
* 2nd Preference:
* 3rd Preference:
Scholarship Request:
I can contribute $ per month.
Please send a copy of last year's 1040 tax return & complete the scholarship application.
How did you hear about MindaMusic?
If other, please specify:
Policies & Payments
 
* I will mail the first session's installment tuition and the $45 non-refundable registration fee per student.
 
* I understand that I am responsible for tuition and music books and agree to all of the Studio Policies.
 
I agree to allow MindaMusic to use photos of and information about my son(s)/daughter(s) on the MindaMusic website and related marketing materials.
Online Signature
 
By providing your full name and the date on which you completed this Online Registration form, you are agreeing that:
- The information you have provided is correct
- That you agree to pay the registration fees and tuition
- That you have read and agree to the Studio Policies
  * Full Name (Including middle initial):
  * Date of Online Registration:
(as mm/dd/yyyy)
* Required
  Enter Security Code  
   

 

Lessons can be scheduled with Ms. Minda via skype or facetime. Please email us to request on online lesson. Click Here

HARP PROGRAMS




Harp registration forms