You may register several ways:

By phone:  Call 859-273-9991 to register with your Visa or MasterCard. 

By mail:  Print off this page to fill out the form, and send care of

Music Institute Registration

3600 Tates Creek Road

Lexington, KY 40517

Please make checks payable to The Music Institute.

By fax: Send to 859-273-8195. 

In person: Call 859-273-9991 to arrange a visit.

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General Registration

Spring 2010

Sign up for:	Price
□ Cycle of Seasons	$150+$30
□ Family Music	$150+$30
□ Petite Pianists: Beginners (twelve weeks)	$200+$30
□ Petite Pianists: Advanced I (twelve weeks)	$200+$30
□ Petite Pianists: Advanced II (twelve weeks)	$200+$30
□ Childbloom Guitar (twelve weeks)	$300
□ Garage Band Coaching, 3-person group (twelve weeks)	$250 each member
□ Garage Band Coaching, 4-person group (twelve weeks)	$188 each member
□ Garage Band Coaching, 5-person group (twelve weeks)	$150 each member
□ Weekly Private Lessons: 16 thirty-minute lessons Instrument:_________________________________	$485
□ Weekly Private Lessons: 16 forty-five-minute lessons Instrument:________________________________	$725
□ Weekly Private Lessons: 16 sixty-minute lessons Instrument:________________________________	$825
□ Music Institute Tote (one required for each new student, unless enrolled in Musikgarten or Petite Pianists)	$25

 

Subtotal: _________________                           

Registration Fee:  $10.00                                     

Total: ____________________                          

Student's Name: _____________________________________________

Age: _____   Birthdate:________  □ Male  □ Female

Parents' Names: ____________________________________________

Address: __________________________________________________

City: __________________________  State: ______  Zip: ___________

Home Phone: __________________  Work Phone: _________________

Cell Phone: ____________________  Email: ______________________

Method of Payment: □ Check  □ Visa/MasterCard                                       

Card #: _____________________________Expiration Date: _________

Authorization to charge credit/debit card:

Signature: ________________________________________________