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REGISTRATION FORM
Parent Name :
*
Student Name :
*
Age:
*
Years:
Months:
- Month -
1
2
3
4
5
6
7
8
9
10
11
Level(if known) :
Address :
*
City :
*
State :
*
Requested Teacher :
*
Zip :
*
(Please enter 10 digits number, no dashes or spaces)
Phone :
*
Alt. Phone :
*
Email Address :
*
Note: Some classes have predetermined days and times.
Please refer to class pages before completing registration form.
Class :
*
- Select Class -
Piano
Voice
Summer Camp Lessons
Composition
Piano Pixies (preschool)
MusikGarten (infant -3)
Adult Piano
Adult Guitar
Violin
Viola
Cello
Home School Music
New/Returning Student :
*
- Select -
New
Returning
1st Preferred Day :
- Select Day -
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
1st Preferred Time :
- Select Time -
9:30 am
10:30 am
11 am
2 pm
2:30 pm
3 pm
3:30 pm
4 pm
4:30 pm
5 pm
5:30 pm
6 pm
6:30 pm
7 pm
7:30 pm
8 pm
8:30 pm
2nd Preferred Day :
- Select Day -
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
2nd Preferred Time :
- Select Time -
9:30 am
10:30 am
11 am
2 pm
2:30 pm
3 pm
3:30 pm
4 pm
4:30 pm
5 pm
5:30 pm
6 pm
6:30 pm
7 pm
7:30 pm
8 pm
8:30 pm
Pfeifer MusicWerks Studio Policies
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Note: Only submit registration form once. It may take a minute or two.
After you register you will be contacted to confirm placement in musicwerksstudio.com
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