Enrollment Form Go backYour message has been sent Student's Name(required) Warning Student's Birthday m/d/y(required) Warning Student's School(required) Warning Parent's Name(s)(required) Warning Cell Phone(required) Warning Home Phone(required) Warning Home Zip Code(required) Warning Parent's Email(s)(required) Warning Does student have any physical/learning disabilites?(required) Yes No Would prefer to discuss in person Warning If Yes, please provide details. Warning How did you hear about Mike Slayen Studios?(required) Warning I understand upon withdrawal of lessons I must inform instructor by email by the 15th of the month prior to withdrawal or following month's tuition is due in full.(required) Agree Warning Comments Warning Mike offers $20 of one month's tuition for your referrals. Do you have any friends that might like to enroll as well?(required) Yes No Warning If yes, you can provide preferred contact info of possible referrals or pass Mike's info to them Warning Warning. Submit Δ Mike check:TweetLike Loading...
Mike Slayen ~ Guitarist 