Accepted Student Enrollment Form

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Student 1: Name *

First

Last

Student 1: Address *

Address Line 1

Address Line 2

City

State

Zip Code

Student 1: Phone *

Student 1: Email *

Student 1: Age *

Under 18
18 or older - adult

Student 1: Birthday *

Student 1: School *

If not enrolled in school, please type "none".

Student 1: Grade *

Parent / Guardian 1: Name *

First

Last

Parent / Guardian 1 of Student 1: Employer Name and Title *

Parent / Guardian 1 of Student 1: Work Phone *

Parent / Guardian 1 of Student 1: Cell Phone *

Parent / Guardian 2 of Student 1: Name

First

Last

Parent / Guardian 2 of Student 1: Employer Name and Title

Parent / Guardian 2 of Student 1: Work Phone

Parent / Guardian 2 of Student 1: Cell Phone

Student 1: Employer and Title *

Student 1: Work Phone *

Student 1: Race

American Indian / Alaska Native
Asian
Black / African American
Hispanic / Latino
White
Other
Prefer not to answer

This information is anonymized and collected for grant reporting purposes, etc.

Do you need to enroll second student? *

Student 2: Name *

First

Last

Student 2: Address *

Address Line 1

Address Line 2

City

State

Zip Code

Student 2: Phone *

Student 2: Email *

Student 2: Age *

Under 18
18 or older - adult

Student 2: Birthday *

Student 2: School *

If not enrolled in school, please type "none".

Student 2: Grade *

Parent / Guardian 1 of Student 2: Name *

First

Last

Parent / Guardian 1 of Student 2: Employer Name and Title *

Parent / Guardian 1 of Student 2: Work Phone *

Parent / Guardian 1 of Student 2: Cell Phone *

Parent / Guardian 2 of Student 2: Name

First

Last

Parent / Guardian 2 of Student 2: Employer Name and Title

Parent / Guardian 2 of Student 2: Work Phone

Parent / Guardian 2 of Student 2: Cell Phone

Student 2: Employer and Title *

Student 2: Work Phone *

Student 2: Race

American Indian / Alaska Native
Asian
Black / African American
Hispanic / Latino
White
Other
Prefer not to answer

This information is anonymized and collected for grant reporting purposes, etc.

Do you need to enroll third student? *

Student 3: Name *

First

Last

Student 3: Address *

Address Line 1

Address Line 2

City

State

Zip Code

Student 3: Phone *

Student 3: Email *

Student 3: Age *

Under 18
18 or older - adult

Student 3: Birthday *

Student 3: School *

If not enrolled in school, please type "none".

Student 3: Grade *

Parent / Guardian 1 of Student 3: Name *

First

Last

Parent / Guardian 1 of Student 3: Employer Name and Title *

Parent / Guardian 1 of Student 3: Work Phone *

Parent / Guardian 1 of Student 3: Cell Phone *

Parent / Guardian 2 of Student 3: Name

First

Last

Parent / Guardian 2 of Student 3: Employer Name and Title

Parent / Guardian 2 of Student 3: Work Phone

Parent / Guardian 2 of Student 3: Cell Phone

Student 3: Employer and Title *

Student 3: Work Phone *

Student 3: Race

American Indian / Alaska Native
Asian
Black / African American
Hispanic / Latino
White
Other
Prefer not to answer

This information is anonymized and collected for grant reporting purposes, etc.

Do you need to enroll fourth student? *

Student 4: Name *

First

Last

Student 4: Address *

Address Line 1

Address Line 2

City

State

Zip Code

Student 4: Phone *

Student 4: Email *

Student 4: Age *

Under 18
18 or older - adult

Student 4: Birthday *

Student 4: School *

If not enrolled in school, please type "none".

Student 4: Grade *

Parent / Guardian 1 of Student 4: Name *

First

Last

Parent / Guardian 1 of Student 4: Employer Name and Title *

Parent / Guardian 1 of Student 4: Work Phone *

Parent / Guardian 1 of Student 4: Cell Phone *

Parent / Guardian 2 of Student 4: Name

First

Last

Parent / Guardian 2 of Student 4: Employer Name and Title

Parent / Guardian 2 of Student 4: Work Phone

Parent / Guardian 2 of Student 4: Cell Phone

Student 4: Employer and Title *

Student 4: Work Phone *

Student 4: Race

American Indian / Alaska Native
Asian
Black / African American
Hispanic / Latino
White
Other
Prefer not to answer

This information is anonymized and collected for grant reporting purposes, etc.

The student agrees to adhere to all school policies upon registration. Please refer to www.washingtonconservatory.org/enroll/policies/ for a list of policies. *

I have read and agree to Washington Conservatory of Music's policies, including the lesson make-up policy.

Student photo release granted upon registration. *

The student understands that they will be directed to pay online immediately after submitting this form. Please refer to www.washingtonconservatory.org/enroll/tuition-and-fees/ for information on tuition and fees. *

I have reviewed the Tuition & Fee Information and understand that no lessons will be given until my payment is received.

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