Application

Member of Boston Central

You can quickly apply by filling out and submitting the on-line application form below. Or you can download and fill out an application form and then send or bring it to us. Or simply call us at (781)784-9079 and we take your application over the phone. This information will help us to setup a lesson schedule that is convenient for you. If several family members take lessons at the Academy let us know if you want them to take lessons at the same time or with the same instructor. Please also familiarize yourself with our Policies and Regulations for Private and Group Lessons and our Academic Calendar.

First Name:

MI:

Last Name:

DOB:

(MM/DD/YYYY)

Street:

City:

Zip:

Contact Info of Adult Student or Legal Guardian:

Telephone:

Email:

	If under 18 years old please complete this section:		Grade:
	Father's Name:		Daytime Phone:

	Mother's Name:		Daytime Phone:

Select Lesson or Program:		Lesson Length:
Instrument at home:
Please describe your experience:

Please list all days of the week and times when you are able to take lessons:

Slot1

Slot2

Slot3

Day

From

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

How did you find out about our Academy:

What else do we need to know about your child?

Name of the person filling out an application:

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