The St. Louis Children's Choirs Online Registration

Registration

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Welcome to The St. Louis Children's Choirs! Please complete the following registration form and submit payment online. We would like to remind that we will take $30 off your tuition if you choose to pay with EFT bank drafts! All accounts are eligible for this discount, even those using tuition assistance. We look forward to singing with your child soon!

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Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info (Not Contact #1 or #2)*

Health Insurance Carrier

Enter Coupon #

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Who is your employer?

Employer

Employer Phone

Employer Notes

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Ethnicity (used for grant purposes only)

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications*

Primary Doctor

Ethnicity - for grant purposes*

Voice Part

Total years in SLCC*

Preferred class section/day

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Another Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Ethnicity (used for grant purposes only)

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications*

Primary Doctor

Ethnicity - for grant purposes*

Voice Part

Total years in SLCC*

Preferred class section/day

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Ethnicity (used for grant purposes only)

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications*

Primary Doctor

Ethnicity - for grant purposes*

Voice Part

Total years in SLCC*

Preferred class section/day

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Ethnicity (used for grant purposes only)

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications*

Primary Doctor

Ethnicity - for grant purposes*

Voice Part

Total years in SLCC*

Preferred class section/day

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Ethnicity (used for grant purposes only)

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications*

Primary Doctor

Ethnicity - for grant purposes*

Voice Part

Total years in SLCC*

Preferred class section/day

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule*

Please fill out CREDIT CARD Payment Method

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number

Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Account Information

Credit Card

eCheck/Bank Draft

Required Policies

(Show-Hide Details)