Register for Nora's MYC Classes

Student Information
Student's Name*: MYC Level*:
Birth Date*: Day and Time of Class*:
Grade and Name of School as of September*:
Parent's Name*:
Contact Information
Mailing Address*: Postal Code*:
Home Phone number*:
Cell number: Work number:
Email address*:
Resources
Instrument(s) at home
How did you hear about MYC?
Word of Mouth Brochure Facebook
Website Advertisement Returning Student
Other (please specify)

Required fields are marked with *.

Student information is for use only by Music for Young Children. It will not be passed or sold to a third party without your written consent.