Community Music School

Adult Piano Lesson Registration

Adult Piano Lesson Registration * need the valid information.

Your Information

Your Name:
* required

Student Age or DOB:

* required

DOB (this will help us with music selection)

Home Address:
* required

Home Phone or Cell Phone:

* required

* required

Piano Experience: Please briefly explain your piano history, if any (again, this will help with our planning)

Registration Confirmation

Permission to Enroll.


Registration Information

Checks payable to: Community Music School

Please make your checks payable to "WIU Community Music School" and give payment directly to the instructor at the first rehearsal of the semester.