2014– 2015 student registration · pdf filesuzuki royal conservatory achievement program...

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2014– 2015 Student Registration Form Father’s Name_______________________ Phone (___)_____________ email:_______________________________ Mother’s Name_______________________ Phone (___)_____________email:_______________________________ Address:_______________________________________________ City:_________________ Zip:________________ Student’s Name_____________________________ Instrument__________________ Teacher__________________ Suzuki Royal Conservatory Achievement Program Traditional REGISTRATION/MONTHLY TUITION Suzuki classes include 8 classes monthly; 4 private, 4 group. The fee is $21.37 per lesson. Fees are based on the actual number of classes for the school year. Tuition is the same each month. CHECK ALL THAT APPLY. Registration . . . . . .1st student). . . . . . . . . . . . . . $95. Registration, each additional student . . . . . . . . . .$75. Recital fee, per semester. . . . . . . . . . . . . . . . . . . . $25. Parent class . . . . . . . . . . . . . . . . . . . . . . . . . . . FREE SUZUKI VIOLIN, , GUITAR, CELLO 30 Minute lessons, 4 group lessons. . . . . . . . . . . $171. 45 Minute lessons, 4 group lessons. . . . . . . . . . . . $255. 60 minute lessons, 4 group lessons .. . . . . . . . . . . $339. *ROYAL CONSERVATORY ACHIEVEMENT PROGRAM * requires permission from the instructor to enroll 30 Minute lessons. . . . . . . . . . . . . . . . . . . . . . . . . .$148. 45 minute lessons. . . . . . . . . . . . . . . . . . . . . . . . . .$222. 60 minute lessons . . . . . . . . . . . . . . . . . . . . . . . . $296. TRADITIONAL PIANO INSTRUCTION 30 Minute lessons. . . . . . . . . . . . . . . . . . . . . . . . . .$141. 45 minute lessons. . . . . . . . . . . . . . . . . . . . . . . . . .$210. 60 minute lessons. . . . . . . . . . . . . . . . . . . . . . . . . .$279. Instrument Rental . . . . . . . . . . . . . . . . . . . . . . . . $30. GENERAL INFORMATION How Did you hear about our program? ____________________________________________ Student’s age:____________________________ Grade in School:__________________________ School attending:_________________________ IMAGE RELEASE I hereby give permission to the Suzuki Institute School of Music, Inc. and any other entity with which the Suzuki Institute School of Music is affiliated, to use my name and photographic likeness, video and audio recording, as well as the name of my children and their photographic likenesses. X__________________________ ____________ Parent signature Date PAYMENT OPTIONS Choose one of the options below. Please print carefully. Registration fee is non-refundable. Tuition is due between the 1st and 15th of each month. Payments must be paid by auto checks or credit cards. Credit card no. ____________________________________________________ exp. Date___________________ Auto Check Bank name:_____________________________________________________________________________________ Account no:______________________________________ Routing no._____________________________________ Date to withdraw funds: 1st 15th As checked [X] above I authorize the Suzuki Institute School of Music, Inc. to withdraw scheduled period elec- tronic funds transfer debits and/or credits from my account identified above for payments due or when applicable, apply electronic funds transfer credits to the same. I understand the dollar amount can vary depending on ser- vices performed or merchandise charged. X_________________________________________ date:________________ print name:_______________________________

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Page 1: 2014– 2015 Student Registration · PDF fileSuzuki Royal Conservatory Achievement Program ... *ROYAL CONSERVATORY A ... above I authorize the Suzuki Institute School of Music, Inc

2014– 2015 Student Registration Form

Father’s Name_______________________ Phone (___)_____________ email:_______________________________

Mother’s Name_______________________ Phone (___)_____________email:_______________________________

Address:_______________________________________________ City:_________________ Zip:________________

Student’s Name_____________________________ Instrument__________________ Teacher__________________ Suzuki Royal Conservatory Achievement Program Traditional

REGISTRATION/MONTHLY TUITION

Suzuki classes include 8 classes monthly; 4 private, 4 group. The fee is $21.37 per lesson.

Fees are based on the actual number of classes for the school year. Tuition is the same each month.

CHECK ALL THAT APPLY.

Registration . . . . . .1st student). . . . . . . . . . . . . . $95.

Registration, each additional student . . . . . . . . . .$75.

Recital fee, per semester. . . . . . . . . . . . . . . . . . . . $25.

Parent class . . . . . . . . . . . . . . . . . . . . . . . . . . . FREE

SUZUKI VIOLIN, , GUITAR, CELLO

30 Minute lessons, 4 group lessons. . . . . . . . . . . $171.

45 Minute lessons, 4 group lessons. . . . . . . . . . . . $255.

60 minute lessons, 4 group lessons .. . . . . . . . . . . $339.

*ROYAL CONSERVATORY ACHIEVEMENT PROGRAM * requires permission from the instructor to enroll

30 Minute lessons. . . . . . . . . . . . . . . . . . . . . . . . . .$148.

45 minute lessons. . . . . . . . . . . . . . . . . . . . . . . . . .$222.

60 minute lessons . . . . . . . . . . . . . . . . . . . . . . . . $296.

TRADITIONAL PIANO INSTRUCTION

30 Minute lessons. . . . . . . . . . . . . . . . . . . . . . . . . .$141.

45 minute lessons. . . . . . . . . . . . . . . . . . . . . . . . . .$210.

60 minute lessons. . . . . . . . . . . . . . . . . . . . . . . . . .$279.

Instrument Rental . . . . . . . . . . . . . . . . . . . . . . . . $30.

GENERAL INFORMATION

How Did you hear about our program?

____________________________________________

Student’s age:____________________________

Grade in School:__________________________

School attending:_________________________

IMAGE RELEASE

I hereby give permission to the Suzuki Institute School of Music, Inc. and any other entity with which the Suzuki Institute School of Music is affiliated, to use my name and photographic likeness, video and audio recording, as well as the name of my children and their photographic likenesses.

X__________________________ ____________ Parent signature Date

PAYMENT OPTIONS

Choose one of the options below. Please print carefully.

Registration fee is non-refundable. Tuition is due between the 1st and 15th

of each month.

Payments must be paid by auto checks or credit cards.

Credit card no. ____________________________________________________ exp. Date___________________

Auto Check Bank name:_____________________________________________________________________________________ Account no:______________________________________ Routing no._____________________________________ Date to withdraw funds: 1st 15th As checked [X] above I authorize the Suzuki Institute School of Music, Inc. to withdraw scheduled period elec-tronic funds transfer debits and/or credits from my account identified above for payments due or when applicable, apply electronic funds transfer credits to the same. I understand the dollar amount can vary depending on ser-vices performed or merchandise charged. X_________________________________________ date:________________ print name:_______________________________