P.A.S. Class Registration Form

(Student Name)

male female........(Gender)

(Date of Birth) (Grade) (School currently attending)

(Mailing Address)

(City) (State) (Zip Code)

(Phone Number) (Best time to contact me)

(Email Address)

(Parent/ Legal Guardian,if under 18)

I wish to enroll in the following Fall class(es):

Monday

8:00 a.m.: Beginning Guitar

3:15 pm: Intermediate Guitar

Tuesday

3:15 pm: Drama Group

6:30pm: Violin

Wednesday

3:15 pm: Keyboard

5:30pm: Adult Beginning Guitar

Thursday

3:15 pm: Choral Performance

Private Lessons

Please list instrument below.

(Comments, Suggestions)