Application for Lessons and Ensembles

Student's Name: Mr. Ms. Mrs.	Last	First	Nickname
Parent Name(N/A if adult) Mr. Ms. Mrs.	Last	First
Mailing Address:
Check here if same as Permanent Address: Number & Street:                       City: St: ZIP:

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Phone 9 a.m. - 4 p.m.: ( ) -	Phone 7 p.m. - 9 p.m.: ( ) -
Birth Date:(N/A if adult)	Today's Date:
E-Mail Address:
How did you hear about the Conservatory Preparatory Division:

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PLEASE COMPLETE EACH ENROLLMENT AREA THAT APPLIES:
It generally takes 14 to 21 days for an application to be processed.

ENROLLMENT IN PRIVATE LESSONS

Instrument: (or voice)

Previous Yrs. of Study:

Are you currently in lessons?

Yes

No

Preferences:

Traditional

Jazz

Lesson time preference - please list five possible days and times for lessons:

1.

2.

3.

4.

5.

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ENROLLMENT IN ENSEMBLES

Please contact me about auditions for:

Junior Winds (grades 6-9)

Columbus Youth Symphonic Band (grades 10-12)

Columbus Youth High School Chorale (grades 9-12)

Current or previous ensemble experiences:

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ENROLLMENT IN MUSIC CLASSES*
Please contact me about the next session of:
Japanese Taiko Drumming Class (Beginning class: 1st grade and up; Mixed level: 12 yrs. and up) Monday evenings

Beginning Voice Class for Adults: Tuesday evenings, 7:10 to 8 p.m.

*(Classes are offered only with adequate enrollments)

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