Elizabeth A. George Violin Studio

Child #1 Name *

First Name

Last Name

Child #2 Name

First Name

Last Name

Child #3 Name

First Name

Last Name

Parent Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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Emergency Contact Name *

First Name

Last Name

Emergency Contact Number *

(###)

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Type of Payment *

Semester

Month

Tuition Policy *

I agree to the tuition policy.

Make-Up Policy *

I agree to the make-up policy.

Sick Policy *

I agree to the sick policy.

Studio Policy *

I agree to the studio policy.

Lesson Weeks *

Please select the weeks you would like lessons.

Week of June 9

Week of June 16

Week of June 30

Week of July 7

Week of July 21

Week of August 4

Week of August 11