Fine Arts Academy - Private Piano Lessons

FULL PAYMENT MUST BE MADE AT THIS TIME.

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Name of student: Name of student: First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Phone Phone - ### - ### ####
The student is a/an:

The student is a/an: Adult Student (Grades 9-12) Student (Grades K-8)
Name of Parent/Guardian (if under 18) Name of Parent/Guardian (if under 18) First Last
Age of Student (if under 18)
Please select the duration and number of lessons you wish to register for:

Please select the duration and number of lessons you wish to register for: 5, 30-Minute Lessons 10, 30-Minute Lessons
Is this your first time enrolling in Private Piano Lessons? If so, select yes, so we can add a $50 introductory supply fee to your order.

Is this your first time enrolling in Private Piano Lessons? If so, select yes, so we can add a $50 introductory supply fee to your order. Yes No
Photo Release
I hereby grant permission to Waynesburg University's Fine Arts Department to use photographs and/or video of me taken during Fine Arts Academy Classes in publications, news releases, online, and in other communications related to the mission of Waynesburg University's Fine Arts Department.

Photo Release I hereby grant permission to Waynesburg University's Fine Arts Department to use photographs and/or video of me taken during Fine Arts Academy Classes in publications, news releases, online, and in other communications related to the mission of Waynesburg University's Fine Arts Department. Yes No
Payment is due at this time.

Your total cost has been calculated. Please remember this amount as it will not be on the payment page.
Are you using a Gift Certificate?

Are you using a Gift Certificate? Yes No
Please enter your Gift Certificate ID # here:

Please enter your Gift Certificate ID # exactly as it is on your gift certificate. After reviewing and submitting this form, you can exit out of the payment window. The Waynesburg University Business Department or the Fine Arts Academy Director will reach out to you if a payment needs to be made.
$0

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Fine Arts Academy - Private Piano Lessons

Fine Arts Academy - Private Piano Lessons

$`0`

Total

Payment is due at this time.

$`0`

Total

Fine Arts Academy - Private Piano Lessons

Fine Arts Academy - Private Piano Lessons

$0

Total

Payment is due at this time.

$0

Total

$`0`

$`0`