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Joys Of Music, Inc. Registration Information

Use this form for enrollment in classes held at Garden of Eden

Student Data
Student's Name:
Age and Date of Birth:
Grade in School (summer – enter next grade):
School Student Attends:
Friends Already Enrolled (used for grouping classes):
Friends You Want to Start Piano in Your Group (referrals):

Parent Data
Parent's Name(s):
Home Mailing Address (address, city, state, zip):
Home Phone #:
Mother's Work #:
Mother's Cell #:
Father's Work #:
Father's Cell #:
E-mail Address:
Special Interests, Learning Challenges, Talents, Hobbies, Skills or Former Experience of your Student: