Student Name *

First Name

Last Name

Parent Name *

First Name

Last Name

Instrument *

Piano

Voice

Lesson length *

30 minutes

45 minutes

60 minutes

Lesson Time *

Please choose one of the following

I would like the SAME lesson time in the Fall

I am willing to keep my lesson time, but would PREFER a new lesson time/day. (Please indicate in comments)

I need a DIFFERENT lesson time/day (Please indicate in comments)

$50 Non-refundable Deposit *

A deposit of $50 for EACH student is due to secure a lesson time for the Fall. The deposit will be applied towards the Fall Trimester tuition in September.

I understand that $50 is required to secure one lesson time for the Fall

Cancelation Policy *

Because we value our teachers’ time, students are able to reschedule up to one lesson per trimester with advance notice. Please understand that Miller Music has multiple teachers (with limited time) that use our space. Contact your teacher 24 hours in advance if you would like to reschedule a lesson time. We are unable to offer makeups for missed lessons.

I understand the Missed/Cancelation Policy

Summer Lessons *

Are you planning on taking Summer Lessons? Week 1: 6/16-22 Week 2: 6/23-29 Week 3: 6/30-7/6 Week 4: 7/7-13 Week 5: 7/14-20 Week 6: 7/21-28 Week 7: 7/29-8/3 Week 8: 8/4-10 *Closed on July 4th Tuition (Payment due by the first lesson): 30 minute lessons: $260 45 minute lessons: $390 60 minute lessons: $520

Yes- We'd love Summer Lessons!

No- But we plan to be back in the Fall!