ACB Student Registration Form
The Awesome Cooper High School Band
Student Registration Form
2010=2011
Please Type or Print:
Grade: ________
Instrument: ___________________________
Student First Name (preferred): ________________________________________
Student Last Name: _________________________________________________
Mailing Address: ___________________________________________________
Student Email Address: ______________________________________________
Student Cell Phone: _________________________________________________
Student Home Phone: ________________________________________________
Current Private Lesson Teacher: _______________________________________
Parent/Guardian Name(s): _______________________________________________
Parent/Guardian Email Address: ________________________________________
Parent/Guardian Cell Phone #1: ________________________________________
Parent/Guardian Cell Phone #2: ________________________________________
(for each cell phone number, please indicate who the number belongs to)
