15600 OLD ROCKFORD RD., PLYMOUTH, MN 55446 • MAP • E-MAIL • CHURCH: (763) 553-1239 • SBCA: (763) 553-3083

SBCA REGISTRATION: MUSIC
Spring, 2010: January 4 - May 22

SPRING 2010 TERM
Our spring term consists of 19 weeks of lessons, spread over 20 weeks (no scheduled lessons March 22-28.).

Weeks remaining in this term: -11

STUDENT INFORMATION - The Student

NAME:

Last Name

First Name

GENDER/DATE OF BIRTH:

Male Female

DOB:

COURSE OF STUDY

LESSON/SESSION LENGTH:

30 45 60 120

CLASS/ENSEMBLE SIZE:

2 3 or more
No need to fill this in if you're registering for a private lesson

PRIOR STUDY:

Number of years of prior study in this course

BILLING INFORMATION - Person paying the tuition.

NAME:

Last Name

First Name

STREET/APT:

Street

Apt

CITY/STATE/ZIP:

City

State

ZIP

HOME PHONE:

WORK PHONE:

CELL PHONE:

E-MAIL:

MEMBER:

Yes No
Member of St. Barnabas? (Used for statistical purposes only)

SUMMER LESSONS are now in session. New students are accepted at any time. Register here!