New School of Music Registration Form 2008-2009
(two pages)
To Print: Use your browser's print command to print this page, fill out form and mail, drop off or fax (credit cards only)
completed Registration Form with payment to:
The New School of Music, 25 Lowell Street, Cambridge, MA 02138
or fax it to 617-864-7318 (Visa/Mastercard/Discover/AmEx payments only)

617-492-8105 (phone)

Please fill out this form after you’ve made arrangements with the NSM office
for your first lesson, trial lesson, group class or chamber music coaching. 

Student’s Name ___________________________________ Birthdate (if under 18) ___/___/___
Student's School ________________________________________  Adult? _______

2^nd Student _______________________________________ Birthdate (if under 18) ___/___/___
2^nd Student's School ______________________________________  Adult? _______

1^stParent/Guardian (if under 18) ______________________________________________________
   Home Address _____________________________________________________________
   City _________________________________________State _______  Zip _____________
    Home Phone ______________ Work Phone ________________Cell Phone _____________
Email ___________________________________________________________________

2^nd Parent/Guardian __________________________________________________________
Work Phone ______________________  Cell Phone _____________________________
Email __________________________________________________________________
    Home address, if separate residence __________________________________________________

Would you like to be added to our concert/event email list?   ___ YES      ___  NO
Are you a new student to NSM?  ___ YES      ___ NO

Student #1   Term you are registering for: SUMMER 2008 ___ FALL 2008 ___  SPRING 2009 ___    
Private Instruction:  Instrument/Voice _____________________   Instructor ________________________
Length of lesson:  30 min. ___  45 min. ___  60 min. ___       # of lessons____   Day_______ Time ______
                (There are 17 weeks in the Fall and Spring terms and up to 11 weeks in the Summer term.)
 Group Class: _______________________________________________________Section: _______

Student #2   Term you are registering for: SUMMER 2008 ___ FALL 2008 ___  SPRING 2009 ___
Private Instruction:  Instrument/Voice _____________________   Instructor _______________________
Length of lesson:  30 min. ___  45 min. ___  60 min. ___       # of lessons____   Day_______ Time ______
Group Class: _______________________________________________________Section: _______
                (There are 17 weeks in the Fall and Spring terms and up to 11 weeks in the Summer term.)

 

Total Tuition:                                                                                                                   $ __________

Registration Fee ($30/one student, $45/family, $15 if summer only):                            $ __________

I/We would like to make a tax-deductible donation:                                                      $ __________

                                                                                                      TOTAL Enclosed:     $ __________

                ___Enclosed is my check made payable to The New School of Music

                ___Please charge my:  Visa ___  Master Card ___ Discover ___  AmEx ___ 

 

Account #: __________________________________________________ Exp. Date:   ____ / ____ 

Signature: ___________________________________________________

 

 

(Click here for a printable scholarship application. Scholarships are made possible, by the generous tax-deductible donations of our students, faculty, alumnae, foundation supporters, and the greater community. These funds are awarded  on a first-come basis each school year, on the basis of financial need, and are renewed in future years based upon annual applications and teacher recommendations regarding student effort and progress.)

In our efforts to serve a diverse community, NSM is often asked to provide anonymous demographic
information for grants. The following optional information would be helpful and kept confidential. Please check all that apply:
Black/ African-American  ____   Native American  ____   Asian/Asian-American ____
Hispanic/ Latino ____   White/Caucasian  ____   Other: ________________________

Please note that photographs taken of classes and events at the New School of Music may be used
in print and online publicity materials to advertise the school or to support grant applications.

Please inform the NSM office by phone or in writing if you
prefer not to be photographed for promotional purposes.

  

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