REGISTRATION FORM for Hochstein School of Music & Dance
SECTION I (Must be completed by all enrolling students)

Student Name
Address	E-mail address
City/State	Zip/County
Employer	Occupation
School attending	Grade (as of 9/05)
Date of Birth/Age	Race (for statistical purposes)
Home Phone	Work Phone

Are you a new student at Hochstein?    Y    N       
Are you, or any member of your immediate family, currently enrolled at Hochstein    Y   N
Have you, or any member of your immediate family, previously registered at Hochstein?         Y    N

For students under 18 years

Father/Guardian Name
Employer	Occupation
Phone (home)	(work)	(cell)
Mother/Guardian Name
Employer	Occupation
Phone (home)	(work)	(cell)

SECTION II (Must be completed by students enrolling in CLASSES)

Course Title	Day	Time
1.
2.
3.

SECTION III  (Must be completed by students enrolling in ENSEMBLES)
Ensemble Name __________________________________________________ Instrument ___________________________________

Please list NYSSMA Solo information below. If you have not participated in the NYSSMA Solo Festival, please use box below to list title and composer of lesson book(s) or other music you have studied.

Title	Composer	Level	Numeric Score
1.
2.
3.

Private Teacher Name________________________________________________________                           
Telephone_______________________________________________
                       
Previous ensemble experience:






SECTION IV (Fees and Payment Options)

Course/Ensemble Title (from above)	Fee
1.
2.
3.
Registration Fee
Total Enclosed

O    Check or Money Order Enclosed

O    Please charge my VISA/MasterCard
        Card Number ____________________________________       (Card # MUST include 3-digit security code located above signature band)
 Expiration Date__________________________

        Cardholder's signature____________________________________________________________________

O    Please automatically charge quarterly payments to the above Credit Card number

REGISTRATION

Register early to ensure greater options of available lesson times and classes. Mailed registrations for Classes and Ensembles must be post marked no later than September 1st. After September 1st, please refer to the Walk-in Registration times.

Enrollment is for the entire 36-week school year with the following exceptions:
18-week offerings:     Music for Tiny Tots, Music for Tots, Jazz Styles: Fun With Jazz Improvisation
12-week offerings:     Flam Jam Percussion Ensemble, Hochstein Percussion Ensemble
9-week offerings:       Nights at the Opera: A History of Excess; Barrage:Alternative Styles for Violin;Beethoven:The Nine Symphonies; The Role of Women Composers in the History of Music; The Bright Lights of Broadway: History of Musical Theatre;
8-week offering:        Cello Choir
6-week offering:        Junior Wind Symphony; Youth Wind Symphony

TO REGISTER
Registration may be done by mail,  fax (585/454-4393), or phone (585/454-4596). Students requesting tuition assistance must register in person by appointment or during Walk-in times, below. Please include first quarter tuition payment and registration fee with form, payable by check, money order, or Visa/MasterCard.

For Classes: (Foundations in Music, Little Mozarts, Theory & History, Dance) Complete Sections I, II and IV of the Registration form.

For Orchestras: Call 585/454-4596 for more information.

For Small Ensembles: Complete sections I, III and IV of the Registration, and submit by mail or fax, only.

Make checks payable to Hochstein School. Visa and MasterCard accepted; no cash.
Registration fee amounts and due dates, as well as tuition fees payable, are as follows:

Program	Due with Registration Form
	Registration Fee	Tuition Fee
The Bright Light of Broadway: A History of Musical Theater Beethoven: The Nine Symphonies Nights at the Opera: A History of Excess The Role of Women Composers in the History of Music Alexander Technique Workshop	$8/per student	Full tuition
Dance	No registration fee	First quarter tuition
Orchestras & Ensembles (except Wind Symphonies) Jazz Styles: Fun with Jazz Improvisation Piano Performance Seminar	$8/per student	First quarter tuition
Wind Symphonies	No registration fee	Full tuition
Music Theory Music History Survey Foundations in Music Little Mozarts History of Jazz	$18/per student*	First Quarter tuition
Private Lessons; by appointment only	$18/per student	payments arranged by Dean's Office

                *maximum of $36 per family

A class admission slip and rules and regulations will be mailed to you upon receipt of the Registration Form and applicable fees.