Enrollment Form - Buffalo Suzuki Strings

Please call our office at 716-743-8728 for information about our program before submitting this application.

Welcome to Buffalo Suzuki Strings! We are looking forward to meeting and teaching you and your child. Once your form has been submitted, you will receive a call from our Buffalo Suzuki Strings office to complete the enrollment process. On your first bill, there will be a one time (per family) registration fee of $35.00

Student's Name *

First

Last

Age *

Gender

Birthdate mm/dd/yyyy *

Street Address *

City, State, Zip *

Parent #1 (Include Prefix: Mr Mrs Ms Dr etc.) *

First

Last

Parent #1 Cell *

Parent #1 Work Phone *

Parent #1 Email *

Parent #1 Place of Employment and Occupation *

Parent #2 (Include Prefix: Mr Mrs Ms Dr etc.) *

First

Last

Parent #2 Cell

Parent #2 Work Phone

Parent #2 Parent Email

Parent #2 Place of Employment and Occupation

Where Did You Hear About Buffalo Suzuki Strings? *

School the Child Attends *

Please list sibling names and ages

Has your Child Ever Studied an Instrument Before? (If So, please explain in details, what instrument, how long, name of teacher, level achieved)

Are there any musicians in the family? Please explain.

Are there any medical, severe allergies or emotional conditions that the teacher should be aware of? *

Please use this space to write any other information that may help us get to know your child or that you might think would be helpful.

Please tell us days and times that you are available for lessons. *

For Office Use Only

Name