2015 Enrollment Form - Monmouth Conservatory Of Music printable pdf download

50 White Street, Red Bank, NJ 07701

email: mcmredbank@verizon.net

732-741-8880

Enrollment Contract Form 2015 - 2016

______________________________

Student Information

Please Print Clearly

Check One: New Student _____ or Continuing Student _____

Name ________________________________ _____________________________

Date of Birth___________________

Last

First

Home Phone (_____)___________________

E-mail: ________________________________________________________

Important for Billing, News, Events, & Updates

Address ________________________________________

City _______________________

State _____ Zip ___________

Adult Studentʼs Employer Name __________________________________

Work Telephone (_____)__________________

Instrument________________________________________

Lesson Length__________________________

Parent/Guardian Information

Complete for Students under 21 years of age

Father/Guardian

Mother/Guardian

Name________________________

_____________________

Name__________________ __________________________

Last

First

Last

First

Phone (_______)_____________ (_______)________________

Phone (_____)______________ (_____)________________

work

cell

work

cell

E-mail_____________________________________________

E-mail____________________________________________

Important for Billing, News, Events & Updates

Place of

Employment__________________________________________

Employment______________________________________

I give Monmouth Conservatory of Music permission to seek emergency medical care for_________________________ until I am able to present.

FALL SEMESTER: September 1st through January 31

SPRING SEMESTER: February 1

through June 30

18 lessons per semester

ATTENDANCE: Students are obligated to a minimum

. Two absences due to illness or

vacation are allowed. Planned absences should be discussed with the teacher at least one week in advance. For absence due to

illness or emergency please contact the teacher or office before the lesson time to cancel. Only two (2) make-ups per semester

are allowed. If the teacher will miss more than two (2) lessons a substitute will be provided.

There are 20–22 weeks in each semester. We encourage students to take more than the minimum 18 lessons. Each additional

lesson brings improvement. Any lessons over the 18-lesson semester minimum will be billed at the per lesson rate.

REGISTRATION & TUITION POLICY: A $45 per year Registration Fee (non-refundable) is due for each student. Tuition is due

in advance of lessons. A $15 per month late fee will be charged for tuition not paid in advance. You will be charged for the full

18-lesson semester.

NEW STUDENTS: Registration is ongoing throughout the year. Semester requirement is pro-rated accordingly. New private

lesson students are required to take a trial period of 4 lessons. Payment for the four (4) lessons and registration fee is due

at time of registration. No refunds. Questions or concerns during the trail period should be discussed with the staff.

WITHDRAWALS: For withdrawal after the trial period, please inform the office immediately after 4th lesson is taken.

PLEASE NOTE: No refund after the fifth lesson is taken. You are responsible for the total 18-lesson tuition for the semester.

PLEASE SIGN BELOW. REGISTRATION WILL NOT BE ACCEPTED WITHOUT SIGNATURE.

By my signature, I (please print your name)__________________________________________________certify that I accept

responsibility for payment of the 18- lesson per semester tuition and fees outlined in this contract-enrollment form and

understand that only lessons paid for in advance will be received.

_______________________________________________________

___________________

Please see information

Parent/Adult Student Signature

Date

on Back

2015 Enrollment Form - Monmouth Conservatory Of Music

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