Mackerman Music Studio-Piano Lessons

   Piano Lessons near  St. Anthony Park, Roseville, Lauderdale, St. Paul, Minneapolis


June 19 - August 1

To register for lessons, please complete and submit the following by 1st lesson:

1. Signed Teacher’s Studio Policy form

2. Tuition: 7 weeks - $196

3. Registration form for each student (below).


Summer Session 2018 Piano Student Registration

Please complete for each student and bring to your 1st lesson.

Student Name: _______________________Nickname (if any) _______

Home Phone: _________Address: ___________________Grade: ____ Age: __ Birthday______

City, State, Zip ________________________________


Mother’s Name/Work Phone:   __________________ Cell Phone: ____________________

Father’s Name/Work Phone:   __________________  Cell Phone:   ___________________  

In case I need to contact this student’s parent during the day, and neither parent can be reached at home, please provide at least one work email address below.

Mother’s Email: ____________________________________________

Father’s Email: _____________________________________________

Emergency Contact Name: _______________________________________

Emergency Contact Phone: ______________________________________

Student's musical experience (if any):



Referred by (if anyone):



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