Program Recommendation Complete this form during the consultation after the first Intro Lesson has concluded. Program Recommendation GENERAL INFORMATION Intro Lesson Date * Teacher Name * Armando Wood Brianna Marra Elena Chao Frank Browne Jean DeMart John Fairbanks Justin Haase Matt Fullove Miss Mindy Robbyn Kirmsse Samuel Mazur Holly Knoch Jujin Chung Peter Walsh Sara Canning Vic Hernandez Parent Name * Parent Name First First Last Last Parent Email * Student Name * Student Name First First Last Last Instrument * Bass Cello Clainet Drums Flute Acoustic Guitar/Electric Guitar Harp Piano/Keyboard Saxophone Trumpet Ukulele Voice Violin Other TEACHER RECOMMENDATIONS Student RCM/RSL Level * NA Prep/Debut 1 2 3 4 5 6 7 8 9 10 Recommended Little School of Music Program * Apprentice w/30-min Lessons Apprentice w/45-min Lessons Apprentice w/45-min Semi-Private Lessons Intermediate w/45-min Lessons Intermediate w/60-min Lessons Advanced w/60-min Lessons College Prep w/60-min Lessons Music for Little Mozarts Class Other (describe below) Other Recommendation ENROLLMENT INFORMATION Lesson Week Day * Monday Tuesday Wednesday Thursday Friday Saturday First Lesson Date * Lesson Start Time * 121234567891011 : 00153045 AMPM Lesson End Time * 121234567891011 : 00153045 AMPM Non Refundable Annual Tuition Down Payment * $199 $299 $399 Homeschool/Charter School First Month Tuition * $47 (prorated for one 30-min lesson) $94 (prorated for two 30-min lessons) $141 (prorated for three 30-min lessons) $188 (four 30-min lessons) $70.50 (prorated for one 45-min lesson) $141 (prorated for two 45-min lesson) $211.50 (prorated for three 45-min lessons) $282 (four 45-min lesson) $94 (prorated for one 60-min lesson) $188 (prorated for two 60-min lesson) $282 (prorated for three 60-min lesson) $376 (four 45-min lesson) $149 (group class) $37.25 (prorated for one 45-min semi-private lesson) $74.50 (prorated for two 45-min semi-private lesson) $111.75 (prorated for three 45-min semi-private lesson) $149 (four 45-min semi-private lessons ) Homeschool/Charter School Total Due Now at Enrollment * (Tuition Down Payment + First Month Tuition) FUTURE PAYMENTS Monthly Installment Payment Amount (11 payments) * $188 (Individual Instruction w/30-min Lessons) $282 (Individual Instruction w/45-min Lessons) $376 (Individual Instruction w/60-min Lessons) $149 (Semi-Private Instruction w/45min Lessons) $149 (Group Class w/60-min Classes) Homeschool/Charter School Pre-Paid Full Annual Tuition (Discounted Rate) * NA $2,041 – Apprentice w/30-min Lessons $2,971 – Apprentice w/45-min Lessons $3,061 – Intermediate w/45-min Lessons $3,992 – Intermediate w/60-min Lessons $4,082 – Advanced w/60-min Lessons $4,082 – College Prep w/60-min Lessons $1,655 – Apprentice w/45-min Semi-Private Lessons Homeschool/Charter School (Includes Tuition Down Payment) Next Payment Due Date * ADDITIONAL INFORMATION Notes / Comments Submitted by Staff Member * Roxanne Mindy If you are human, leave this field blank. Submit