Enrollment Form

Student's Name
Age	Birthdate
School	Grade Dismissal Time
Parent/Guardian's Name
Address
City and Zip	, TX
Home Phone
Work Phone
Mom's Cell Phone
Dad's Cell Phone
E-Mail
Instrument of Study:
Type of Lessons
When do you wish to begin lessons?	Fall Summer
Desired day of lesson:
Desired time of lesson:
Desired Length of Private lesson
Do you have siblings that need to be scheduled together?	Yes (how many? ) No
If desired, list teacher preference
Special requests or concerns:
Any special needs or learning disabilities that we need to be aware of?
Please submit one enrollment form along with a $50 non-refundable registration fee per student made out to Vicki Gray for each child you wish to enroll in music lessons for the current term. If you are presently enrolled in the Gray School of Music, this registration will appear on your MAY INVOICE. Registration fees are due once a year and can be brought to the studio or mailed to Gray School of Music, 11661 Preston Rd. Suite 136, Dallas, TX 75230. Please see the tuition page and policies page for more information about billing and recurring payments. If you have not already been scheduled for your first lesson with a teacher, someone will call you to schedule lessons as soon as this form is received and processed. All form fields are required except the last three, so if a field does not apply to you, please enter "NA".

11661 Preston Rd.
Suite 136
Dallas, TX 75230

Office phone:
214-369-7772