EAT-Center form

Registration For Music Lessons Open Houses Lessons & Seminars

Participant Registration Form
Name: *

First Name Last Name
Student Name: *

First Name Last Name
E-mail *
Specify which area you interested in? *

Piano Lessons Number System Open House Voice Organ Drums Recording Production Software Bass Guitar Songwriting/Music Business
Phone Number *
Age of student:
Church Affiliation:
Select best day and time that best fit your schedule: For lessons only

Monday 1pm-5pm Monday 5pm-9pm Tuesday 1pm-5pm Tuesday 5pm-9pm Thursday 1pm-5pm Thursday 5pm-9pm Friday 1pm-5pm Friday 5pm-9pm Saturdays
City & State *
Write about your experience even if it's none and most importantly what you wish to learn *
Who and how did you hear about us? *
To avoid spam please type text. *
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Registration For Music Lessons Open Houses Lessons & Seminars