The Heights - Fine Arts Institute

Student Registration Form
Please fill out all of the information in the form below:

Student Information:
Last Name
First Name
Middle Name
Birth Date

Address
City, State, Zip
Home Phone
Office Phone
Cell Phone
Pager
Email Address

Experience:
Beginner (no previous experience)
Intermediate (2-4 years experience)
Advanced (5 years or more experience)

Preferred Day:
Tuesday
Wednesday
Thursday

Parent Information:
Mother's Name
Father's Name

Address
City, State, Zip
Home Phone
Office Phone
Cell Phone
Pager
Email Address

Instruction Desired:

Private Lessons
Piano
Guitar
Voice
Percussion/Drum Set
Bass Guitar

Class Instruction
Guitar
Voice
Drama
Garage Band
Art
Ballet (Age 3-5)
Ballet (Age 6-7)

Fall Semester
Spring Semester
1/2 Hr. Lesson
3/4 Hr. Lesson
1 Hr. Lesson

T-Shirt Size:
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
Adult XXXL
Youth Small
Youth Medium
Youth Large

Comments:

Contact Rob Platter in the Worship Ministry Office at rplatter@theheights.org for more information