Nantucket Community Music Center Online Registration

Registration

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This form begins the process of getting you (or your student) registered for lessons at the NCMC. Once completed, we will contact you directly to book your private lessons with your teacher, and process payment for registration and the semester's tuition.

Winter 2021/ January 4 - March 27

Tuition Rates and Fees:
30 min. lessons: $37.00
45 min. lessons: $53.00
60 min. lessons: $67.00

Registration Fee: $50 per family per year.

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

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

Contact #1

Contact #1 First Name*

Last Name *

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

Student #1

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Skill Notes

Please select from your areas of interest below.

If you are a returning student, please note your preferred time and instructor in the comments section at the bottom of the form.

Thank you!

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Skill Notes

Please select from your areas of interest below.

If you are a returning student, please note your preferred time and instructor in the comments section at the bottom of the form.

Thank you!

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Skill Notes

Please select from your areas of interest below.

If you are a returning student, please note your preferred time and instructor in the comments section at the bottom of the form.

Thank you!

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Skill Notes

Please select from your areas of interest below.

If you are a returning student, please note your preferred time and instructor in the comments section at the bottom of the form.

Thank you!

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Skill Notes

Please select from your areas of interest below.

If you are a returning student, please note your preferred time and instructor in the comments section at the bottom of the form.

Thank you!

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

(Show-Hide Details)

General Policies

I've read the above and agree.

Attendance Policies

I've read the above and agree.

Payment Policies

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

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*

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)

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 and Agreements (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

Required Policies and Agreements

(Show-Hide Details)