Name: Suzuki Piano Book 1B Group Class
SKU: Suzuki Piano Class-1-1
Price: 36.00 USD
Availability: InStock

Student Name*

I am currently enrolled in*

EMA Private Instruction
I am a new student to EMA

Student Birthday*

Preferred Pronoun

Other Preferred Pronoun

Student Email (if applicable)

Student Cell Phone (if available)

Student Address*

Is your student Hispanic/Latino?

Yes, Hispanic/Latino
No, not Hispanic/Latino
Prefer not to answer

This information is collected to help EMA with grants and other reporting. Hispanic/Latino ethnicity is a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Choose only one.

What do you consider your student's racial heritage to be? (Mark any that apply)

American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Prefer not to answer

This information is collected to help EMA with grants and other reporting.

Grade in School (as of Sept. 1)

Current School (as of Sept. 1)

Parent #1’s Name*

Parent #1’s Cell Phone Number*

Parent #1’s Email*

I would like to enter an additional Parent’s contact information*

Yes
No

Parent #2’s Name*

Parent #2’s Cell Phone Number*

Parent #2’s Email*

I would like to enter an additional person’s contact information*

Yes
No

Additional Contact’s Name*

Additional Contact’s Cell Phone Number*

Additional Contact’s Email*

Does your child have any special needs of which we need to be aware?

How did you hear about EMA?

I grant my permission to be included in Encore Music Academy's promotional materials/media productions.*

I grant my permission
I do not grant my permission

I grant permission to be included in Encore Music Academy's promotional materials and multi-media productions which may include pictures and/or video/audio recordings on website, social media and in newspapers.

By completing this form you agree to the Terms & Conditions

Security Question: What is the first letter in Encore?*

Encore Music Academic

Suzuki Piano Book 1B Group Class

Description

Related products

EMA Youth Orchestra

Suzuki Piano Book 2+ Group Class

EMA Youth Orchestra Concerto Competition

Suzuki Violin Group Class