top of page

Text 845-741-3145

Home
About Us
Remote Lessons
- Remote Learning Testimonials
Patreon
Recitals and Events
Shop
Blog & Videos
Forms and Documents
More

Use tab to navigate through the menu items.

Student Enrollment Form

Student Information

First name

Last name

Date of birth

Age

Grade

Start Date at MMS

Phone

Email

Address

Country/Region

Address

City

Zip / Postal code

Studied Piano?

Yes

No

If yes, how long?

If yes, with whom

Studied Voice

Yes

No

If yes, how long?

If yes, with whom?

Responsible Guardian Information

First Name

Last Name

Spouse/Alternate Guardian

Phone

Email

Multi-line address

Country/Region

Address

City

Zip / Postal code

Auditions

Federation

Yes

No

Years

Score

Guild

Yes

No

Years

Score

MTNA

Yes

No

Years

Score

NYSSMA

Yes

No

Years

Score

RACE

Yes

No

Years

Score

Masters Classes

Yes

No

Years

Score

Attendance/Schedule

Note: Days and times will be assigned based upon availability. Once lesson times are assigned, you may be asked to change to another weekly teime or day if the Sudio scheudl shifts.

Lesson Subject- check all that apply*

Piano

Music Theory

Voice

Lesson Type

In-person

Remote

Combination- in-person and remote as requested

Day of the week- check all available

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Time First Choice

Time Second Choice

Miller Music Studios Policy Aknowledgement and Signature

I certify that I have read the entire Mmiller Music Studios Policy and agree to its terms and conditions.

Yes

Full Name

Date picker

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Download Enrollment Form

OPENING HOURS

Open 7 days a week, by appointment only. Lessons available upon request.

MILLER MUSIC STUDIOS

158 Commonwealth Ave.

Middletown, NY 10940

Text or Call: 845-741-3145

Email: info@millermusicstudios.com

SUBSCRIBE FOR UPDATES

bottom of page