Workshop Application

Darshell's Quality Music And Entertainment, Inc.
P.O. Box 255
Ridgewood, NJ 07451
(201) 370-8664
darshellsqualitymusic@verizon.net

Music Workshop Application In order to enroll in this music program, fill out the form below. The types of music classes are as follows: 1. Piano/Keyboard Lessons (basic music theory included) 2. Vocal Lessons (basic music theory included) 3. Music History/Advanced Music Theory Courses 4. Music Composition/Music Production Fill in the number(s) that correspond(s) with the type of music class the student is interested in taking.
Name:
Email:
Student:
Age:
Street Address:
City, State, Zip:
Home Telephone Number:
Work Telephone Number:
Mobile Telephone Number:
Fax Number:
Type of Music Class:

Give The Gift Of Music
To Someone You Love

$25.00 Gift Certificate
1 week/music lessons

$50.00 Gift Certificate
2 weeks/music lessons