Workshops Online Registration

Student 1: For which program or programs are you registering?*

How to Record, Professionally (4 weeks)
Practice Strategies for String Players (4 weeks)
Alexander Technique School Year
Create & Imagine Theory Classes (7 weeks)

Student 2 (if any): For which program or programs are you registering?

How to Record, Professionally (4 weeks)
Practice Strategies for String Players (4 weeks)
Alexander Technique School Year
Create & Imagine Theory Classes (7 weeks)

Student 1*

First Last

Student 1 Date of Birth*

Student 1 Grade In or Grade Entering*

Student 1 Instrument*

What instrument do you play (primarily if more than one)? or is voice your primary "instrument"?

Student 2

First Last

Student 2 Date of Birth

Student 2 Grade In or Grade Entering

Student 2 Instrument

What instrument do you play (primarily if more than one)? or is voice your primary "instrument"?

Parent/Guardian 1*

First Last

Parent/Guardian 1 Email*

Parent/Guardian 1 Phone*

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Parent/Guardian 2

First Last

Parent/Guardian 2Phone

Parent/Guardian 2 Email

How did you hear about us / find us?*

Word of Mouth (via a friend, relative, neighbor, another student, etc)
Facebook
Print Media (print ads, newspapers, calendar postings, etc)
Attended an event
Search Engine (google, bing, etc) / web site
Other Web Site
Teacher Referral
Brochure/Rack Card / flier (Library or other venues)
Other

Ethnicity for Grant Reporting Purposes: Primary Parent*

Your response is appreciated and can be helpful in our ability to secure grant funding. Information is gathered for reporting purposes only.

Ethnicity for Grant Reporting Purposes: Child One*

Your response is appreciated and can be helpful in our ability to secure grant funding. Information is gathered for reporting purposes only.

Ethnicity for Grant Reporting Purposes: Second Child (optional)

Your response is appreciated and can be helpful in our ability to secure grant funding. Information is gathered for reporting purposes only.

Photo/Video Consent*

Do you give Pakachoag Music School permission for yourself and/or your child(ren) to be photographed and/or videotaped during school functions and activities for school purposes and for such photos or videos to be used commercially by the school, including postings on the School web site. We do not post names publicly (but may make a specific request, individually, if so desired).

Yes
No

Please review our Program policies at this link prior to completing registration, and confirm your acceptance below. Look for "Other Group Programs" on the website site policy page. Please note that we are unable to provide refunds for group programs. Registration & School Policies

Consent*

I agree to the school policies.

Tuition*

Please confirm here the payment amount you will submit by checking the appropriate box.

How to Record, Per Student: $95
Practice Strategies for Strings, Per Student: $125

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Online Workshops Registration Form

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