Academy of Music
Registration Form

Student Name *

First Name

Last Name

Student Date of Birth *

MM

DD

YYYY

Parent or Gaurdian Name

If under the age of 18

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Secondary Phone

optional

(###)

###

####

Instrument / Music Program *

Select which Instrument or Music Program you are interested in taking lessons for.

Piano

Violin

Viola

Cello

Guitar

Bass Guitar

Music Theory

Music Composition

Gender

Female

Male

Other

Prefer not to answer

Ethnicity

Select all that apply

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Other

Languages Spoken

Select all that apply

English

Spanish

Mandarin

Arabic

French

German

Other

Agreement to Terms *

- I acknowledge the Oxford Arts Alliance’s right to adjust or terminate enrollment based on progress, attendance, or policy non-compliance. - Tuition is a non-refundable monthly subscription. Cancellations or absences do not warrant refunds. Lessons canceled with at least 24 hours notice are eligible for a makeup session. Cancellations within 24 hours of the lesson forfeit the session without a makeup. Mid-to-end month enrollments will be prorated. - Academy membership is mandatory for lesson enrollment. I agree to uphold my yearly membership and adhere to academy policies.

Agree to Terms