Georgia Center for the Arts → Meet the Teachers → Registration Form

2010-11 Online Registration for Private Lessons
Note: Please fill out a separate form for each sibling in the same family
  

I'd like someone to contact me for available teachers and times:	I'm ready to register online and pay the registration fee:

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PLEASE CONTACT ME FOR TEACHER INFORMATION
Name:
Email:
Phone number:
Instrument:
Preferred teacher(s): (leave blank if no preference)
Preferred days and times of the week:

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ONLINE REGISTRATION
Student Name:		Student Email:
Student Home Phone:		Student Cell Phone:
Student School:		Grade Level:

 

SUPPLEMENTAL INFORMATION
Parent/Guardian Name:		Parent/Guardian Address:
Parent/Guardian City/State/Zip:		Parent/Guardian Cell Phone:

 

HEALTH INFORMATION
Physician Name:		Physician Telephone:
Emergency Contact Name:		Relationship to Student:
Emergency Contact Number:		Special Medical Needs:
LESSON DETAILS
Instrument:
Preferred teacher(s): (leave blank if no preference)
Preferred days and times of the week:

 

 Policies & Procedures

To receive information regarding scheduling, rates, and other information, please contact the Cobb Symphony at info@cobbsymphony.org.

Cobb Symphony Orchestra | Murray Arts Center at Mount Paran Christian School | 2250 Stilesboro Road | Kennesaw, Georgia 30152
Phone: 770-429-7016 | Fax: 770-794-8916 | © 2010 Cobb Symphony Orchestra | webmaster