Withdrawal Form Student Name * First Name Last Name Lesson / Class * Art ( Private Lessons) Bass Cello Clarinet Double Bass Drum Flute French Horn Guitar Oboe Piano (Private Lesson) Saxophone Trumpet Ukelele Viola Violin Voice Art Group Class Piano Group Class Choir Lesson Length 30 Mins 45 Mins 60 Mins Group Class Who was your instructor? * How were you enjoying lessons? Love it Liked It It was good It could be better I don't like it Reason for dropping * Schedule Conflicts Budget Charter School Funding Lost Interest Left Area Personal Issues Need a Break Summer Break In a couple of sentences, please explain why you are withdrawing from lessons: * How was your teacher? * What can we improve upon? * Policy Acknowledgments * By clicking below, I am agreeing to abide by the policies outlined in the registration form. Students are held responsible for their last month’s tuition if withdrawal is after the 15th of the previous month, whether or not they attend lessons. When a withdrawal occurs after the 15th of the month, the charge for the next month will still go through. When ready to return, any missed lessons that were paid for may be credited, the student above might not be able to be placed with the same teacher/day/time and will start at the begining of the Musical Ladder Program. A new registration fee may be required upon re-enrollment. I have read, understand, and agree to abide by these policies. Parent Name * First Name Last Name Email * Phone * (###) ### #### Name First Name Last Name Thank you!
