Rock Band Form

Please fill out the information below to be considered for current band openings, or to be placed on our wait list for future openings.

Please be sure to review our POLICY & PRE-REQ’S information prior to submitting this request form

Policy / Pre-Req's Review

I have reviewed the rock band policy and pre-req's pages prior to submitting this form.

YES

Student Name

First Name

Last Name

Student Age

Student Availability

What schedule availability does your student generally have for lessons during the week?

Instruments

What instrument(s) would your student be interested in playing in a band?

Music Interests - Artists

Please provide at least 5 of your student's favorite artists / rock bands.

Music Interests - Songs

Please provide at least 5 favorite songs that your student may be interested in performing as a rock band. (Note: instructor will attempt to incorporate the interests of all rock students. This information is just to give us an idea of the student's current interests.)

Original Music Interest

Has your student shown any interest in writing / performing any original music? If so, tell us more!

Parent/Guardian Name

First Name

Last Name

Phone

(###)

###

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Additional Parent/Guardian Contact (optional)

(please provide if there will be an additional parent involved as a scheduling contact)

First Name

Last Name

Phone

(###)

###

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Tell Us More

Please let us know a little about your student(s)' experience with music thus far. I.E. How much experience with the instrument(s), any lessons/instruction to date, any helpful info etc.

How did you hear about us?

web search, referral, ads, etc