please fill out this form in its entirety and return it ......suzuki program fill out the form below...

BSS Summer Workshop August 12 - 16, 2019 Suzuki Program

Fill out the form below and return it with the student information form and full payment to:

Buffalo Suzuki Strings, 4 Webster St., N. Tonawanda, NY 14120

Deadline for registration: June 30, 2019 Applications received after this date will be accepted based on

availability.

Early registration bonus: Sign up before May 31 and receive a discount!

No refunds after July 15.

A workshop T-shirt is included for everyone: please circle a size.

Youth XS S M L Adult S M L XL

Payment (circle): check cash credit card

Amount: $____________ Zip Code: ____________

CC# ___________________________________________

Expiration _______________ Security code ___________

Signature________________________________________

Please fill out this form in its entirety and return it with your full payment. No refunds after July 15.

One student per form.

STUDENT INFORMATION

Name: ______________________________________ Age: ________

Address: _________________________________________________

Parent(s) Names: __________________________________________

Phone: ___________________ E-mail: _________________________

Instrument: _______________ Teacher: ________________________

SUZUKI PROGRAM INFORMATION Please complete to ensure proper class placement.

Most polished piece: ____________________ Suzuki Vol. No. ______

Current piece: _________________________ Suzuki Vol. No. ______

Reads music? _________ Examples: ___________________________

What orchestras or ensembles does the student participate in?

_________________________________________________________

Class Tuition

Discount tuition, prior

to May 31 Amount Paid

Introduction to the Suzuki Method (2 hrs) $225 $200 $____________

Suzuki Program, books 1-5 (3 hrs) For students playing Violin, Viola, Cello, Piano & Classical Guitar $325 $300 $____________