Spring 2017 Online Registration Form

Student Name *
Student Name
Birthdate
Birthdate
Address
Address
Parent Name (if applicable)
Parent Name (if applicable)
Home Phone *
Home Phone
Cell Phone
Cell Phone
Group Class/Ensembles
Please check all that apply. Please note that there is a one-time annual registration fee of $30 per student or $45 per family.
Please note that there is a one-time annual registration fee of $30 per student or $45 per family.
The dates and times I wish to register for are available. *
Please indicate your assigned proposed lesson time here. (Ex: 4:30pm)
If you are registering for a private lesson, please indicate your preferred lesson length.
Full Academic Year Registration *
Save time by registering for the full academic year today! No additional registration forms required and full-year students are always given preference if they need to make changes to their schedule.
Please note that there is a mandatory 1 hour consultation with the Music Therapist prior to the start of any program. $99
Donate to our Scholarship Fund Today!
I'd like to make a donation to the Music For All Scholarship Campaign in the amount selected below. I understand that this donation will provide a young musician in need with necessary tuition assistance.
Sibling Discount
Please don't forget to check this box if you have more than one member of your family currently studying at NCMS so you can receive your 5% Tuition Discount!
Are you New to NCMS? *
If new to lessons, please indicate your preferred start date or simply write: "as soon as possible". Please note that all lesson tuition will be pro-rated to your preferred start date.
Please state any additional notes here.
My Electronic Signature below indicates my agreement with all school policies listed on our website: www.nashuacms.org/registrationpolicies, including an annual registration fee of $30 per student for $45 per family. I understand that my online registration will not be complete until I submit a $100 deposit per student to NCMS to secure my lesson time. If the deposit is not received within 3 business days of this form, I understand that I am in jeopardy of losing my assigned time.