PO Box 40, Yarmouth, Maine 04096 (207) 751-8031
REGISTRATION FORM 2008-09
Please complete and return with your season tuition by mail or in person by September 16, 2008.
Membership fee (September-May): $175 per student, $150 for subsequent members of family. Checks should be made payable to MYO. All fees must be paid in full by September 16, 2008 and are non-refundable.
Financial aid is available for students who need assistance in paying their annual membership fee. Please contact the MYO Board of Directors at PO Box 40, Yarmouth, ME 04096 or call 207-751-8031 for more information.
Amount Due__________ Amount Paid_________ Check no._______
Student’s Name_____________________________________________Birth Date_________________________________
Mother’s Name_________________________________Father’s Name__________________________________________
Student’s Address_____________________________________________________________________________________
_______________________________________Phone Number____________________Cell phone____________________
Student’s e-mail______________________________________________________________________________________
Parents’ e-mail_______________________________________________________________________________________
How often is e-mail checked? ______daily_____several times per week_______weekly__________less than once a week
What is the best way to contact student?_________________________________________________________________
School____________________________________________________________________Entering grade____________
Primary Instrument__________________________Years of Study________Currently taking lessons?_______________
Music Teacher’s Name & Phone_______________________________________________________________________
Music Camps or Workshops Attended (include dates)_______________________________________________________
__________________________________________________________________________________________________
New Members: How did you hear about MYO?_____________________________________________________________________
________________________________ __________________________________
Student signature Parent Signature
Publicity Release Consent
I understand that MYO’s publicity materials may include statements by and/or photographs of MYO participants, and I consent to such use of my child’s comments and photographic likeness.
Parent Signature/Date