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 class(es):

Private Lessons

Keyboard

Please post any comments below.

(Comments, Suggestions)