Lisa Marie's Music Programs
2010-11

Please fill out the form below, make your payment choice, click submit, and complete your payment option via Pay Pal.

Student's name
Parent's name
Mailing Address

E-mail address
Best phone number(s)
Recorder Experience Beginner  Intermediate
Has the student
read music before?		 Yes  No
If yes, explain.
Age and grade
School
Which payment plan
would you prefer?		 Full ($330)
Two Payments ($180.00/$150.00)
Three Payments ($130.00/$100.00/$100.00)