2. How do I start?: Submit a student information form
The steps are simple:
  1. Complete and submit the Student Information Form or contact us by phone (336-379-8748) with your interest.
  2. We contact you with a potential instructor.
  3. You coordinate the type of lesson and lesson time with the instructor.
  4. Register with the office by email, postal mail, telephone, or in person.
  5. You begin "lessons for life."
Read our privacy policy.
REFERRED BY
STUDENT INFORMATION
First Name:
 Last Name:
Adult        Child
Age Grade
   Date of Birth - Required for ECE
    /   / 
Address:
City:
 State:                                                  Zip:
    
Home Phone:
( )  -  		Work Phone:
( )  - 
Cell Phone:
( )  -  		Email Address:
PARENT INFORMATION
Mother
Home Phone:
( )  -  		Work Phone:
( )  - 
Cell Phone:
( )  -  		Email Address:
Father
Home Phone:
( )  -  		Work Phone:
( )  - 
Cell Phone:
( )  -  		Email Address:
INTERESTED IN --  be specific
 Keyboard  Early Childhood
   
 Vocal  Camp
   
 Instrumental  Birthday Party
   
 Ensembles  Partnership with a school
   
MUSICAL BACKGROUND --  indicate institution(s) and year(s) of study
 Never studied music
 Keyboard  Vocal
   
 Instrument(s)  Ensemble(s)
   
 Early Childhood Education  School programs(s) [be specific]
   
 Most recent private teacher
  		 Most recent literature completed
 
 Reason/need for lessons
  		 Ultimate Goal
 
 Teacher(s) requested
 
 Type of teacher requested; needs and/or personality of student
 
 Additional information
 
AVAILABLE FOR LESSONS
  Mon   Tue   Wed   Thu   Fri   Sat   Sun  
AM                     
PM                     
 Additional availability information
 
 

MANC Privacy Policy:
The Music Academy of North Carolina will not share, sell or otherwise let any outside organization review, have or copy our personal information files. This includes applications, enrollment records and website activity. We will not share our email addresses or sell our email address to any other party.

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