Student Information Sheet - Teri Slade

Student Information Sheet

This form is an alternate method of submission for your or your child's student information. All students have the option of submitting their information in hard copy. The electronic form is intended for convenience.

Student

* Indicates required field

Name *

First

Last

Date of birth *

Mailing address *

Alternate mailing address (if guardians do not share an address) *

Preferred payment option *

Instrument (piano and/or voice) *

Year the student began/will begin lessons on their chosen instrument(s) *

Allergies *

Any medical conditions of which the teacher should be aware *

Any additional information of which the teacher should be aware *

Guardian 1 (if applicable)

Name *

First

Last

Relation to student *

Home phone *

Cell phone *

Work phone *

Email address *

Best method of contact *

Guardian 2 (if applicable)

Name *

First

Last

Relation to student *

Home phone *

Cell phone *

Work phone *

Email *

Best method of contact *

Submit