Complete all applicable information, (*) denotes a required field.
Student's First & Last Name:*
Your Name:*
Student's Date of Birth:
(if under 18 years of age)
 Male
 Female
Student's Age:
Student's Home Address:*
Is off-street parking available for the music instructor?
 Yes
 No
Is on-street parking available for the music instructors?
 Yes
 No
Student's Email Address:
Confirm Email Address:
Student's Home Phone
Number(s):*
Student's Cell Phone
Number(s):
I am a currently enrolled student with Music Notes Academy and my contact information is the same.
Adult Students Please Skip Section Two & Continue To Section 3
Mother's First & Last Name:
Mother's Home Address:
Mother's Daytime Phone Number:
Mother's Cell Phone Number:
Mother's Evening Phone Number:
Mother's Email Address:
Confirm Mother's Email Address:
Father's First & Last Name:
Father's Home Address:
Father's Daytime Phone Number:
Father's Cell Phone Number:
Father's Evening Phone Number:
Father's Email Address:
Confirm Father's Email Address:
Emergency Contact Information:
In case of an emergency, whom should
be contacted in the event a parent
cannot be reached?
Please Describe Any Special
Considerations Or Medical Conditions
Music Notes Academy Instructors
Should Be Aware Of:
Choose All That Apply From The Following
Drums, Percussion
 Electric Guitar
 Audio Engineering, Recording
Piano
 Acoustic Guitar
 Music Technology, Production
Voice
 Classical Guitar
 Song Writing, Composition
Brass
 Bass Guitar
 Music Theory, Arranging
Woodwinds
 Strings
 Other
When would you like to begin music lessons? See our Academy Calendar page for session dates.
Immediately, upon availability
 Winter Session 2010
 Summer Session 2010
At the beginning of next month
 Spring Session 2010
 Fall Session 2010
Lesson Durations, Choose Your Weekly Lesson Length
30-Minutes
 75-Minutes - Recommended!
 120-Minutes
45-Minutes - Recommended!
 90-Minutes
60-Minutes - Recommended!
 105-Minutes
I have spoken with the director regarding appropriate lesson duration:
 Yes
 No
Preferred Lesson Day & Time
List the day(s) of the week and time(s) you would like to have your weekly music lessons
1st Choice
2nd Choice
3rd Choice
Describe Your Availability For Lessons If Needed
In the event your preferred lesson day(s) and time(s) is(are) not available you will remain on our waiting
list and receive confirmation when your preferred lesson day(s) and time(s) becomes available. Students
will only remain on our waiting list if registration fee ($45) is submitted.
Describe Any Musical Background and/or Prior Experience
Briefly Describe Your Musical Goals and Aspirations
Describe, if any, learning/educational disabilities
Trial Music Lessons
Would you like to start with a trial music lesson or interview with the Academy Director before you begin your
weekly music lessons?
Yes, I would like to start with a trial lesson/interview.
No, I am ready to begin my music lessons.
Our Music Teachers
Would you like to request a specific music teacher for your lessons? If so, please enter your preferred
music teacher's name.
_Bands Perform Live In Our Annual Winter Concerts & Spring Student Recitals!
Bands & Group Classes Registration
Please visit our Bands & Ensembles
page for information on our
ensembles, bands and group
classes.
 Percussion Ensemble
 Jazz Keyboard Workshop II
Jazz Band I, Beginner
 Rock Band I, Beginner
Rhythm Section Workshop
 Rock Band II, Intermediate
Rock Band III, Advanced - Part 1
Rock Band IV, Advanced - Part 2
_Bands & Group Classes Per Band Registration/Materials Fee: $50
Questions & Comments:
How Did You Hear About Music Notes Academy?*
Promotional Code or Referral Family Last Name:
Academy Policies: I understand to ensure students receive the most comprehensive and well-rounded
music education, students and parents are required to adhere to Music Notes Academy's Academy
Policies. I have read Music Notes Academy's Policy Statement on the Policies page and understand and
agree to the terms and conditions as outlined and described. I understand I will receive a personal and
complete copy of Music Notes Academy's Policies at or before the first music lesson and will have the
opportunity to discuss MNA's policies with the director before our music lessons begin.
Initial Here: (Parents please initial for students under 18 years of age)
I understand there are no make-up lessons for Summer Session student absences.
 Yes
I understand during the school year I will be allowed three make-up lessons - only if I
schedule the student absence(s) by using the "current students" page (on this website)
with more than 24-hours notice before the start time of the scheduled lesson.
 Yes
Yes, I understand, if I am an adult student (18 years and older) the minimum amount of
instructional time per lesson is 60-minutes.
 Yes
When is the best time to speak with the director regarding your registration?
Call me in the morning!
Call me in the afternoon!
Call me in the evening!
Please Mail (non-refundable) $45 New Student Registration To:
Music Notes Academy
New Student Registration
PO Box 8035
Bridgewater, NJ 08807-8035

Thank you for registering with Music Notes Academy! You will be contacted shortly by the director to
discuss your registration, music education and musical goals.

Online Student Registrations are processed in the order they are received and are not official until
Registration Fee ($45) is received by Music Notes Academy. Thank you for choosing Music Notes Academy,
your music education is very important to us.
After pressing "submit" you'll be able to print the following page.
1.) Complete our online student registration form below and mail in your $45
Student Registration payment.
2.) The director will contact you to discuss your music education.
3.) Submit your first month's tuition payment before your first scheduled music
lesson and you can Learn Today, Play Tomorrow®!
3 Easy Steps!
music lessons in the student's home New Jersey
music lessons in the student's home New Jersey
music lessons in the student's home New Jersey
music lessons in the student's home New Jersey
Music Lessons Available In
Drums
Percussion
Acoustic Guitar
Classical Guitar
Electric Guitar
Bass Guitar
Piano
Voice
Music Technology
Music Production
Song Writing
Composition
Music Theory
Harmony, Arranging
Audio Engineering
Audio Recording
Strings - New!
Woodwinds - New!
Brass - New!
drum lessons in the student's home new jersey
Drum Lessons   Guitar Lessons   Piano Lessons   Bass Guitar Lessons   Voice Lessons   Music Production & Audio Engineering Lessons
Student Registration
music lessons in the student's home New Jersey
We require a
student's address
in order for us to
determine
teacher
availability and
travel time
between lessons.
National Guild of Community Schools of the Arts Member Music Notes Academy
Trial Music Lessons
Interview With The Academy Director
Trial music lessons or in-person interviews with the director are $45 for
approximately 30-minutes. If you would like to schedule a trial music lesson before
registering for private music instruction please specify in your Student Registration
below.
Music Lessons are
available from
2:00 - 10:00 PM
weekdays and
8:00 - 6:00 PM on
weekends. We also
offer lessons during
weekday mornings
and afternoons.
Call Us! (908) 577 - 5905
Private Music Lessons In The Student's Home
Students can register for music lessons anytime throughout the school year or
summer months. Transfer students (students from other community schools, music
education providers, music stores or private music instructors) are encouraged to
register for a trial lesson with the Academy Director for performance evaluation,
assessment and proper instructor compatibility matching. Music lessons occur in the
student's home each week, on the same day and time, with a qualified music
instructor from September to June in accordance with our academic school year
calendar.
music lessons in the student's home New Jersey
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_About Music Notes Academy
Music Notes Academy is a community music school and New Jersey in-home music lesson provider. Music
lessons, available for young children, adolescents and adults, are tailored towards each student, in the
comfort and convenience of the student's home, within our comprehensive music curriculum.

Our unique curriculum includes music theory, practical musicianship skills, such as sight reading and ear
training, proper instrument techniques, classical, jazz, contemporary and popular repertoire - students will
learn songs they want learn as well. Each week, students will receive comprehensive music instruction from
our experienced and educated music instructors. Our instructors combine structure and flexibility which offers
a great balance in music education.
Students can additionally perform with our ensembles and bands, such as percussion ensembles and Rock Bands. Our ensembles and bands
perform in our annual Winter Concerts and Spring Student Recitals which commence in Madison, NJ in an auditorium on stage.
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Reproduction of website content is strictly prohibited, contact Music Notes Academy for reprint permission.
Copyright © 2009 Music Notes Academy, LLC. All Rights Reserved.

Website By Brandon Kurzawa for Music Notes Academy, LLC
Music Notes Academy, LLC
Learn Today, Play Tomorrow®
PO Box 8035
Bridgewater, NJ 08807-8035

Music Notes Academy Office: (908) 577 - 5905

Learn Today, Play Tomorrow is a registered trademark of Music Notes Academy, LLC. All rights reserved.
Music Notes Academy Receives 5 Stars!
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