Request for information

If you are interested in attending classes at The Children's School of Music, please complete and submit the information below.  One of our representatives will contact you with information on the class that best fits your needs.  We hold high standards in confidentiality.  We will never release information about our customers or potential customers.

Please provide the following contact information:

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

Please provide information on the student:

First Name
Last Name
Age

Select your first and second choice for class day

Monday
Tuesday
Wednesday
Thursday
Friday

Select your preference in times for class

Morning
Early afternoon
Late afternoon
Evening

Enter your comments or questions in the space provided below.


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Contact Us:

The Children's School of Music, LLC

P. O. Box 53

Midland, MI  48640

(989) 633-0063

 

Created by Trisha Kayden.
Copyright © 2003 [The Children's School of Musci]. All rights reserved.
Revised: 08/03/06