J & L School of Music 2011-2012
Providing a Teaching Service for Home School Students
Application for all Classes

GENERAL INFORMATION

Parent or Guardian Name
Mailing Address
Mailing Address 2
City
State
Zip Code
Home Phone
Cell Phone
Work Phone
Email

 

EMERGENCY INFORMATION

Contact Phone Number
Contact 2 Phone Number

 

STUDENT INFORMATION (Youngest to Eldest)

Classes: EC-Early Childhood Music, E-Elementary Music, BB-Beginning Band,
I-Intermediate, A-Advanced Band
1. Name Grade Age Class
2. Name Grade Age Class
3. Name Grade Age Class
4. Name Grade Age Class
5. Name Grade Age Class

 

LESSON INFORMATION

Please select the day and location of the classes
Mondays / Richardson Wednesdays / Lucas
Tuesdays / Sunnyvale Thursdays / McKinney

 

REFERRAL INFORMATION

How did you find out about J & L School of Music?
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