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Private Lessons Registration

Please complete the form below to register for lessons or programs with the Stetson University Community School of Music.

Checks should be made payable to Stetson University. Credit cards are accepted. A 10% discount is available to Stetson University employees and parents registering more than one student.

Student Information

Student First Name

Student Last Name

Student Age (if under 18)

Student Grade

Additional Notes and Special Needs

Parent/Guardian Information

Personal Information

Parent/Guardian First Name

Parent/Guardian Last Name

Home Phone Number

Cell Phone Number

Work Phone Number

Email Address

Mailing Address

Street 1

Street 2

City

State/Province

ZIP/Postal Code

Country

Programs

Musical Instrument

Please select a program to which you would like to register.

Full Term (10 Lessons)

Half Term (6 Lessons)

Full Term (10 Lessons)

Abbreviated Term (6 Lessons)

Are you continuing lessons from Spring or Summer 2020?

Yes

Check the boxes that indicate the following

I am a Stetson University employee.

Stetson University ID Number

I am registering multiple students.

Please provide all of your students' names

Please make sure you fill out a separate form for each child.
Each child must have the same parent/guardian listed.

How did you hear about us? (Optional)

Who referred you?

Payment Information

Payment Method

Amount:

To set up a payment plan, please contact Sara Scarpelli ([email protected]) after submitting this form.

Checks may be submitted to the School of Music administrative office, located on the first floor of Presser Hall, between 8:00 a.m. and 4:30 p.m., Monday-Friday.

Checks may also be mailed to Sara Scarpelli at the Community School of Music, 421 N. Woodland Blvd., Unit 8399 DeLand, FL 32723