Student Information

Student #1 Full Name

Lesson Length *

30 min weekly, AGES 4-6, $160/month

45 min weekly, AGES 7-11, $235/month

60 min weekly, AGES 12+, $315/month

If you don't have another student to register, skip to the Availability section -->

Student #2 and DOB (optional)

Instrument and duration for Student 2

Student #3 and DOB (optional)

Instrument and Duration for Student 3

Availability

Please include all the availability you have for lessons in your home each day of the week. Include as much availability as possible to help us pair you with a teacher best, and you may also include any preferences as well.

Mondays *

Tuesdays *

Wednesdays *

Thursdays *

Fridays *

Saturdays *

Sundays *

Start Date

If you are signing up within 4 weeks before our next semester start date (see below), we will have you begin with our next semester.

Fall: Aug 20-Dec 23

Spring: Jan 6 - June 15

Summer: June 15 - Aug 15 (tentative dates)

If you are registering any other time of year, we usually get students into a schedule within 2-4 weeks. Please let us know if you have a specific start date or semester in mind, or if you would like to start asap:

Parent Information

Primary Parent's Full Name (account holder) *

Primary Parent's Email *

Primary Parent's Phone *

Emergency Contact

Please enter the name of a second adult in the home whom we can contact if there is an emergency or issue and you can't be reached: *

2nd Adult's Phone Number *

Your Address

Address Where Lessons Will be Held *

City *

State *

Postal code *

Almost there!

May we use videos or photos of your child/children in our promotional materials online or in print? *

Yes

How did you hear about us? *

Promo Code?

Notice for students starting in the summer semester: Due to the fact that your availability and the teacher's availabilities are very different in summer, there is a chance we may need to switch your teacher in the fall semester. That is never our intention, and we always try to see ahead so that students have the same teacher for as long as is possible, but the schedules change dramatically from summer to fall. We will always do all we can to keep students with their current teacher!

Please read and agree to our policies: https://shiningstarmusicacademy.com/policies-1

Do you agree to our policies shared above? *

Yes

Please share your goals for the student, any experience they have had in their instrument, and other notes that would assist us in helping you find the best teacher:

Press the "submit" button and you will be required to pay a $50 deposit per family on the next screen.

NOTE: If the "submit" button isn't working, a box wasn't filled in correctly. Please scroll to the top of the form to see how to solve the issue

!! If you don't receive an email confirmation after submitting this form, it did not go through!

email us at [email protected] if you have issues or call 352-519-3999