Fall 2010

Please fill out the following form to register for Fall 2010. The Fall term runs from August 9, 2010 to December 16, 2010.

A seperate form is required for each student.

Fall Registration Fee $40 per family

Choose 1 or more of the following instruction offered:

Piano	Trumpet	Flute
Guitar	French Horn	Drums
Trombone	Baritone	Saxophone
Voice	Tuba

Choose 1 or more of the following form of instruction:

Fall Term, 18 Classes-$375.00-Classes meet for 30 minutes and are scheduled afternoons between the hours of 1:00 pm and 5:30 pm

Private Lessons-18 Classes-$625.00 Classes meet for 30 minutes and are scheduled afternoons between the hours of 1:00 pm and 5:30 pm

Rock Band $425.00, Classes meet for 45 minutes and are scheduled for Fidays between 5:00-5:45 pm

Children’s Choir $250.00, Classes meet for 30 minutes and are scheduled for Tuesdays between 5:30-6:00 pm

Payment Options: Choose One

Option 1 Pay semester fees in full at time of registration **Cash, check or credit card** (10% discount if registered and paid in FULL by Friday September 3rd)

Option 2 Pay the semester fees in monthly payments **CASH OR CHECK ONLY**(Classes $75 per month, Private Lessons $125, Rock Band $85 and Choir $50)

Cash, Check or Credit Cards Accepted. Monthly payments are due by the first day of each month. Monthly invoices will not be mailed out.

Electronic Signature of Responsible Party:

Date:*

Student Name:

Select one:

New to Manzi's Music Returning Student

Age if under 18:

Grade in school: School Attending:

Does student have any special needs we should be aware of?:

No Yes

If yes, please explain:

Parent/Guardian:

Address:

City:

State:

Zip Code:

I have read and I agree to Manzi's Music Policy and Agreement Form. You may download a copy on the forms page of our website.

YES

Phone Number:

Cell Phone:

Email Address:

Check if CHANGE OF ADDRESS since last registration

Please contact us if you have questions or would like more information|www.manzismusic.com|(863)709-1401

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