Enrollment Form RCMNY Enrollment Students Students Full Name * DOB * Gender * plus1 Add another Student minus1 Remove Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Primary Number to Reach You * Phone Type * Home Cell Email Provide us with a valid e-mail address and we’ll use it for sending invoices, announcements & school closing notifications. (We will not share this info with others). If student is under 18: Parent(s)/Guardian(s) Name Occupation Phone plus1 Add Another Parent/Guardian minus1 Remove In order to best serve our students’ needs, it is important for us to be aware of any learning, emotional or physical challenges that exist. Please share: How Did You Hear About US? * Student’s Primary Ethnicity * African-American Asian/Pacific Islander Caribbean Caucasian Hispanic Native American Bi-racial (please specify)Bi-racial (please specify) Other (please specify)Other (please specify) ** The following optional information is very helpful to us in applying for grants. Thank you! ** Instrument(s)/Course(s): * Preferred Instructor(s) * Student Type * New Student Returning Student Previous music instruction * Please check your preferred lesson dates and times. Scheduling is done on a first-come, first-served basis. Day * Mon Tue Wed Thu Fri – Virtual Only Sat Between Time * 121234567891011 : 0030 AMPM and * 121234567891011 : 0030 AMPM plus1 Add another Date/Time minus1 Remove Non-refundable Registration Fee (required upon enrollment) * $50/student $75/family $30/ tuition assistance applicant (registration fee is per academic school year and required at time of enrollment) Select Lessons Individual Lessons - 32-weeks - Pro-rated 30-min - $1,600 - $50 45-min - $2,400 - $75 60-min - $3,040 - $95 Suzuki Lessons - 32-weeks - Pro-rated 30-min - $1,920 - $60 45-min - $2,720 - $85 60-min - $3,200 - $100 Music for Life lessons - 32-weeks - Pro-rated 30-min - $2,112 - $66 45-min - $2,992 - $93.50 60-min - $4,224 - $132 plus1 Add (if there is another student) minus1 Remove Group Classes Group Classes - Full Year String Orchestra $450 Percussion Ensemble $450 Teen Choir $450 Burr Bear Music 8 weeks $120 Music for Life Chorus Group Classes Young Adult Tu 5:30 – 6:30 Summer Musical Theatre Workshop $600 Summer Guitar and More Workshop $225 Please contact the main office for Music for Life Lessons and Groups String Orchestra - (Prerequisite Book 4 and or Audition Required) plus1 Add (if there is another student) minus1 Remove PAYMENT OPTIONS * Full Payment 100% at enrollment BI-PAYMENT PLAN 50% at enrollment; remainder January 1 MONTHLY-PAYMENT PLAN 25% at enrollment; remainder paid monthly TUITION ASSISTANCE PLAN 10% at enrollment; remainder paid monthly *** Late Payment: In the event that payment is not made in a timely manner, lessons may be suspended. Name On Card * Card # * EXP Date * Card Authorization * YES, I authorize RCM to charge my credit card on the payment due dates automatically. Click Here to View Policies PHOTO/VIDEO PERMISSION Students and families are frequently photographed or videotaped during Conservatory activities and these photographs may appear inpublic newspapers, newsletters, websites, social media, etc. I give permission for me or my child to be photographed for such purposes * Yes No Policies and Procedures * YES, I have read and agree to follow RCM Policies and Procedures. Captcha Submit