Request for Lessons Form

Thank you for your interest in studying Violin/Viola with the Weems-Elliot Violin Studio.  Registration

generally takes place in June and/or September. Students may also be accepted during the school year

if there is an opening available. If the studio is currently full, students can be placed on the waiting list

if they would like. Please complete the information below. You will receive a response as soon as

possible.

 

                      

                      

Information:

 Student Name:                                                              Age:

         

 

Type of School:  Home School          Public School           Private School

 

 

Instruments the student plays and years studied:

1.      2.

 

3.      4.

 

 

Instrument the student wants to study:    Violin               Viola

 

 

Availability:                     Today's Date:

                 

 

 Parent's Names:

 

 

 City:                               State:

           

 

 Home Phone:                  Cell Phone:                          Email:

           

 

How did you hear about this Studio? Please list the name of the person if applicable.

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                  Lessons are taught on Tuesdays and Thursdays 11:00am - 8pm

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Comments:

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Copyright © 2010 Weems-Elliott Violin Studio. All rights reserved.
Revised: 01/13/10.