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 Jean-Paul (JP) Jones John Fairbanks Joshua Castillo Justin Haase Matt Fullove Miss Mindy Robbyn Kirmsse Samuel Mazur Holly Knoch Susan Carpenter 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