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