(*=required fields) *Student's Full Name *Email Address I would like to keep our spot(s) and will submit the payment for the next session. Group Class Name / Instrument 1 Teacher (private lessons only) Lesson Day/Time Group Class Name / Instrument 2 Teacher (private lessons only) Lesson Day/Time Group Class Name / Instrument 3 Teacher (private lessons only) Lesson Day/Time I will not be continuing lessons for the next session Group Class Name / Instrument 1 Teacher (private lessons only) Lesson Day/Time Group Class Name / Instrument 2 Teacher (private lessons only) Lesson Day/Time Group Class Name / Instrument 3 Teacher (private lessons only) Lesson Day/Time I would like to change the time/day/teacher/instrument for the next session (please list details): If change is not possible: I will keep the current spot I will discontinue lessons Other comments:
