Music Academy Registration Form – Thomas Jefferson Independent Day School

For additional information about the Academy, music lessons, or where to acquire instruments, read our TJ Music Academy policies for after-school lessons or contact Ms. Cutler at rcutler@tjeffschool.org.

Student Name*

Current School*

Current Grade*

Birthdate*

Parent Names*

Parent E-mail Address*

Street Address

Address block

City State ZIP Code

Primary Phone Number(s)

Instrument

Preferred day of the week (select one or more)

Preferred lesson length

Preferred start time

Number of Lessons Requested (Summer Session Only)

Tuition Payment Options*

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Required *