NY String Academy

# STUDENT INFORMATION

* NAME

GENDER

*DOB

* AGE

STREET

APT#

CITY

STATE

ZIP

SCHOOL

GRADE

# PARENT / GUARDIAN INFOMATION INFOMATION

PRIMARY CONTACT

* NAME

RELATIONSHIP TO STUDENT

* CELL PHONE

HOME PHONE

WORK PHONE

* EMAIL

REFERRED BY

# PAYMENT INFOMATION

Tuition must be paid in full 14 day before the first lesson or class. We accept payments by cash, check, Visa, Mastercard, or debit cards. All credit card payments have to be made in person. All checks should be made payable to NY String Academy and msiled to 1224 Anderson ave #1 Fort Lee, NJ 07024

* PREFERRED PAYMENT METHOD

The undersigned has approved the payment amount and infomation above, and also has read and agreed to the NY String Academy Policies. [Policy]

* PARENT'S SIGNATURE

DATE

Registration Form

# STUDENT INFORMATION

# PARENT / GUARDIAN INFOMATION INFOMATION

# PAYMENT INFOMATION