WISCONSIN CONSERVATORY OF MUSIC
pre-registration form (lessons)
this form is for current students only.

Billing Name
Student Name
Address
City, State, Zip

INSTRUMENT
TEACHER
LESSON
LENGTH
BRANCH
(P,W,R,S)
# OF
LESSONS
START
DATE

To help serve you better, please check the spaces below if you think you will be continuing private lessons for additional semesters. We will bill you at the beginning of each semester without requesting another signed pre-registration form. You will be able to change your decision when you receive your bill with no penalty.

If you are changing your lesson length, please check here.
Please bill me for the Spring 2005 semester.
Please bill me automatically for the Summer 2005 semester
Please check here if the senior discount applies to student (age 55+)



You may also mail this completed form to:
Wisconsin Conservatory of Music
Attn: Registrar
1584 N. Prospect Ave
Milwaukee, WI 53202

Fax: 414-276-6076