Community Music School

Adult Group 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

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