Register as soon as possible. Submit to Music Office. Deadline is Saturday October 25th.

Student’s Name ___________________________________________Age__________

Address__________________________________________________________

City_________________________ Zip___________________

Primary Phone ______________________ Parent’s Name _____________________

Email___________________________________________________________

CM Level ‘09_____________ Grade _________ Birthday  ___________________          

Prior CM Student?   YES    NO (circle one)        Last CM Level completed__________

Name of instructor for last level achieved? (If other than RVP Instructor)

_________________________ Former Branch______________________________

(One-Time Fee)
MTAC CM Testing Fee  $25 (Prep)     $35 (1-2)       $40 (3-5)      $45 (6-7)   $50 (8-9)

(Monthly Fee)                        +                       +                          +                   +               +

CM Preparation Class   $40/mo          $40/mo         $40/mo         $40/mo     $40/mo

Total Due Today =         $65.00            $75.00         $80.00          $85.00       $90.00

*Monthly fee is $40 for CM preparation class (Nov-Mar) due the 1^st of each month. This will be added to your Auto-Pay tuition the months of Dec, Jan, Feb, and Mar. The MTAC testing fee is a one-time only fee.

Parent

Signature___________________________________________Date_______________

CM Preparation Class Day _____________Time ________First Class Date______________