Register for The Zion Academy of Music

Please complete the form below:

The required fields are marked with '*'

Student First Name*

Student Last Name*

Email Address*

Referred By*

Address*

City*

State*

State/Province/Pref.*

Zip Code*

Home Phone*

Add Another

Do you want to add parent information?

YesNo

Parent/Guardian Cell Phone#

Can parent/guardian receive text messages?

Please list additional students (include ages) here:

What instrument or class is the student interested in? Please list all. (ex. group guitar, private piano, musical theater, etc.)

We are open M-TH from 10:00-6:00. Fridays are by special request only. What times/days are best for your schedule? Please list at least two options.

Has the student taken music lessons before? If so, please list instruments and length of time for each.

Name of Charter School and ES, if applicable.