Registration

2012-2013 Enrollment is ongoing.

Lessons are scheduled on a first-come first-served basis so enroll today!

Group class dates and times are listed on our Group Class Schedule. For Happy Piano classes, please use the Saturday or Monday enrollment forms.

Enrollment Form

Students may register for lessons or classes at any time during the school year. If the school year has already begun, fees will be pro-rated according to the number of lessons remaining. Lesson times are allotted to students on a first-come, first-served basis.

Please fill out the form below and a member of our staff will contact you to discuss scheduling and payment (available payment plans), and answer any questions you may have.

PLEASE NOTE: By clicking on the "submit" button, you are acknowledging that you have read and agree to our Policies.

Required *

Student Information

History * new student returning student
First Name * Last Name *
Date of Birth * Age
Gender Male Female Not Specified

Second Student Information

History new student returning student
Student's First Name Student's Last Name
Date of Birth Age
Gender Male Female Not Specified

Contact Information

Address *
City *
State * Zip *
Email *
Home Phone * Cell Phone

Parent or Guardian Information (if student is under 18)

First Name Last Name
Occupation Work Phone

Additional Student Information

In order to better serve our students' needs,
please indicate any learning, emotional or physical disabilities that exist.
How did you hear about us?
Promo Code
Student's primary ethnicity (check all that apply)
The following information is used solely when applying for funding.
African-American Asian/Pacific Islander Caribbean Caucasian/White
Hispanic Native American Bi-Racial Other

Program Information

Instrument or Class

Preferred Instructor

Suzuki Method Yes No

Lesson Type Individual Group

Previous Musical Instruction

Days Preferred *

(please indicate as many as possible)

Monday Tuesday Wednesday

Thursday Friday Saturday

Times Preferred (please indicate as many as possible)

9am - 11am 11am - 1pm 1pm - 3pm

3pm - 5pm 5pm - 7pm 7pm - 9pm

Please give us any additional information that may be helpful in placing your student with a teacher or scheduling lessons. If you have any questions, please let us know.

Staying in Touch

I would like to be added to your mailing list for (check all that apply)
Faculty and student concerts Fund-raising events
Newsletter and Press Releases I do not want to receive any communication from RCM

Rockland Music Conservatory

Registration

2012-2013 Enrollment is ongoing.

Enrollment Form

PLEASE NOTE: By clicking on the "submit" button, you are acknowledging that you have read and agree to our Policies.