Parent/Guardian Name *

First Name

Last Name

Phone

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Student Name

First Name

Last Name

Class Registration *

Select your class. Make sure it's the correct date/time/location of the class you want. If you have any questions about the options or do not see your class please contact me at helloharmonymusic@gmail.com.

Beginner Ukulele-9 Week Session /Sept 14-Nov 9/Port Jefferson Village Center/ Thursdays 10:30-11:15 am

Ukulele Experience *

Select one

None

Yes, with other instructor/in school

Yes, with hello harmony music/ Becky Schwartz

How did you hear about us? *

Word of Mouth

Community Flyer/Pamphlet/Notice

Social Media

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Other (specify in comments above)

Class Policies & Terms of Agreement *

I am aware that it is my responsibility to know class policies & Terms of Agreement. I acknowledge that I understand the class policies outlined in the Terms of Agreement and agree to follow all policies. I further understand that registration and payment for this class is an acknowledgement that I understand and agree to class policies & Terms of Agreement.