CMDC REGISTRATION FORM - Fall 2008

Class size is limited. Registrations will be accepted by mail or in person beginning August 1, 2008 on a first-come-first served basis.

(Checks only.) Please make your checks payable to USC School of Music - CMDC and write your child's name on your check.

To enroll, print and return this registration form with your check to USC School of Music - CMDC, 813 Assembly, University of South Carolina, Columbia, SC 29208. You

For more information please contact the graduate assistants at 777-4065 or email: CMDC@mozart.sc.edu.

Your registration will be confirmed e-mail by Friday, August 29, 2008.

Child's Name (first and last): _________________________________

Child's Age: _______Sex: ____ Date of Birth: _____/____/_____

Parent(s)/Guardian(s):______________________________________________

Phone Number(s):_________________________________________________  

Email:__________________________________________________________

Address:________________________________________________________

City:______________________________,SC  Zip:______________________

Please circle your first choice for class day and time. (Assume you will be placed in your first choice unless you hear otherwise.)

A B C D E F

Please circle your second choice for class day & time. (Because classes fill quickly, this selection should be an acceptable alternative if your first choice is unavailable.)

A B C D E F

Please Read & Sign - I understand that each class will be video-recorded for the purpose of music development research by Dr. Valerio and her graduate students and for the purpose of teacher training sessions at conferences and seminars worldwide. I also understand that my child’s identity and the identity of the caregiver(s) who accompany my child to class will be protected. 

Parent Signature:_______________________________Date:___________________ 

Please circle how you found us!

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