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Private Lessons
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GRSM Jam Band
Choirs – Viva Voce
Chamber Music Program
GRSM Band Program
Homeschool Music
Homeschool Band
Homeschool Choirs
Homeschool Jam Band
Homeschool Group Classes
Homeschool Private Lessons
Early Childhood Music
Summer Music Programs
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Summer Private Lessons
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Registration
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Form test page
Home
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Form test page
GRSM Registration Form 2022-2023
GRSM Registration Form with student info above each registration name
Semester
(Required)
School Year 2022-2023
Summer 2023
Responsible Party Name
(Required)
Email
(Required)
Phone #1
(Required)
Phone #2
Address
(Required)
Responsible Party Signature
I hereby take full responsibility for payments to the Greater Richmond School of Music (GRSM) for lessons scheduled in accordance with the availability provided in this form or in other communication with GRSM,
and have read and agree to the School Policies listed at the top of this form in the drop down tab
. If applicable, I authorize GRSM to charge the credit card provided.
Signature
(Required)
Date
(Required)
MM slash DD slash YYYY
Student 1
Full Name
(Required)
Birth Date
(Required)
MM slash DD slash YYYY
Age
(Required)
Gender
Male
Female
Please note IEP, special need, allergies, etc.ed. Enter "none" if not applicable.
(Required)
School Currently Attending
(Required)
Type of Class Requested
(Required)
Choose one or more types
Private / Semi-Private Lessons
Group Class
Private/Semi-Private Lesson Sign-Up
Please indicate ALL available locations/days/times in order of preference.
Add (+) lines where necessary. Students will be contacted with their assigned time approximately 1 week before the first lesson.
(Required)
Hidden
Student 1 Private Lesson
Hidden
Student 1 Private Lesson Age
Student 1 private lesson
(Required)
Instrument
Experience
Current Lesson Book
Lesson Length
Location
Teacher Preference
List ALL Available Days
Earliest Possible Start Time
Latest Possible End Time
Add
Remove
For location please select GRSM/TSI/ONLINE etc.
I am interested in semi-private lessons with another student of similar age/level (if available)
Yes
No
Specific student requested
Number of Summer Lessons Desired
List All Available Weeks for Summer Lessons
School Year Start Date
Group Class Sign-Up
Student 1 Group Class
(Required)
Class Name
Instrument
Experience
Location
Session Fall/Spring/Full Year
Day
Time
Add
Remove
For location please select GRSM/TSI etc.
Any More Students to Register?
Yes
No
Student 2
Full Name
(Required)
Birth Date
(Required)
MM slash DD slash YYYY
Age
(Required)
Gender
Male
Female
Please note IEP, special need, allergies, etc.ed. Enter "none" if not applicable.
(Required)
School Currently Attending
(Required)
Type of Class Requested
(Required)
Choose one or more types
Private / Semi-Private Lessons
Group Class
Private/Semi-Private Lesson Sign-Up
Please indicate ALL available locations/days/times in order of preference.
Add (+) lines where necessary. Students will be contacted with their assigned time approximately 1 week before the first lesson.
(Required)
Hidden
Student 2 Private Lesson
Hidden
Student 2 Private Lesson Age
Student 2 private lesson
(Required)
Instrument
Experience
Current Lesson Book
Lesson Length
Location
Teacher Preference
Lis ALL Available Days
Earliest Possible Start Time
Latest Possible End Time
Add
Remove
For location please select GRSM/TSI/ONLINE etc.
I am interested in semi-private lessons with another student of similar age/level (if available)
Yes
No
Specific student requested
Number of Summer Lessons Desired
List All Available Weeks for Summer Lessons
School Year Start Date
Group Class Sign-Up
Student 2 Group Class
(Required)
Class Name
Instrument
Experience
Location
Session Fall/Spring/Full Year
Day
Time
Add
Remove
For location please select GRSM/TSI etc.
Any More Students to Register?
Yes
No
Student 3
Full Name
(Required)
Birth Date
(Required)
MM slash DD slash YYYY
Age
(Required)
Gender
Male
Female
Please note IEP, special need, allergies, etc.ed. Enter "none" if not applicable.
(Required)
School Currently Attending
(Required)
Type of Class Requested
(Required)
Choose one or more types
Private / Semi-Private Lessons
Group Class
Private/Semi-Private Lesson Sign-Up
Please indicate ALL available locations/days/times in order of preference.
Add (+) lines where necessary. Students will be contacted with their assigned time approximately 1 week before the first lesson.
(Required)
Hidden
Student 3 Private Lesson
Hidden
Student 3 Private Lesson Age
Student 3 private lesson
(Required)
Instrument
Experience
Current Lesson Book
Lesson Length
Location
Teacher Preference
List ALL Available Days
Earliest Possible Start Time
Latest End Possible Time
Add
Remove
For location please select GRSM/TSI/ONLINE etc.
I am interested in semi-private lessons with another student of similar age/level (if available)
Yes
No
Specific student requested
Number of Summer Lessons Desired
List All Available Weeks for Summer Lessons
School Year Start Date
Group Class Sign-Up
Student 2 Group Class
(Required)
Class Name
Instrument
Experience
Location
Session Fall/Spring/Full Year
Day
Time
Add
Remove
For location please select GRSM/TSI etc.
Any More Students to Register?
Yes
No
Student 4
Full Name
(Required)
Birth Date
(Required)
MM slash DD slash YYYY
Age
(Required)
Gender
Male
Female
Please note IEP, special need, allergies, etc.ed. Enter "none" if not applicable.
(Required)
School Currently Attending
(Required)
Type of Class Requested
(Required)
Choose one or more types
Private / Semi-Private Lessons
Group Class
Private/Semi-Private Lesson Sign-Up
Please indicate ALL available locations/days/times in order of preference.
Add (+) lines where necessary. Students will be contacted with their assigned time approximately 1 week before the first lesson.
(Required)
Hidden
Student 4 Private Lesson
Hidden
Student 4 Private Lesson Age
Student 4 private lesson
(Required)
Instrument
Experience
Current Lesson Book
Lesson Length
Location
Teacher Preference
Lis ALL Available Days
Earliest Possible Start Time
Latest Possible End Time
Add
Remove
For location please select GRSM/TSI/ONLINE etc.
I am interested in semi-private lessons with another student of similar age/level (if available)
Yes
No
Specific student requested
Number of Summer Lessons Desired
List All Available Weeks for Summer Lessons
School Year Start Date
Group Class Sign-Up
Student 2 Group Class
(Required)
Class Name
Instrument
Experience
Location
Session Fall/Spring/Full Year
Day
Time
Add
Remove
For location please select GRSM/TSI etc.
Any More Students to Register?
Yes
No
Student 5
Full Name
(Required)
Birth Date
(Required)
MM slash DD slash YYYY
Age
(Required)
Gender
Male
Female
Please note IEP, special need, allergies, etc.ed. Enter "none" if not applicable.
(Required)
School Currently Attending
(Required)
Type of Class Requested
(Required)
Choose one or more types
Private / Semi-Private Lessons
Group Class
Private/Semi-Private Lesson Sign-Up
Please indicate ALL available locations/days/times in order of preference.
Add (+) lines where necessary. Students will be contacted with their assigned time approximately 1 week before the first lesson.
(Required)
Hidden
Student 5 Private Lesson
Hidden
Student 5 Private Lesson Age
Student 5 private lesson
(Required)
Instrument
Experience
Current Lesson Book
Lesson Length
Location
Teacher Preference
List ALL Available Days
Earliest Possible Start Time
Latest Possible End Time
Add
Remove
For location please select GRSM/TSI/ONLINE etc.
I am interested in semi-private lessons with another student of similar age/level (if available)
Yes
No
Specific student requested
Number of Summer Lessons Desired
List All Available Weeks for Summer Lessons
School Year Start Date
Group Class Sign-Up
Student 2 Group Class
(Required)
Class Name
Instrument
Experience
Location
Session Fall/Spring/Full Year
Day
Time
Add
Remove
For location please select GRSM/TSI etc.
Payments
A down payment of $60 per student ($40 for group students) is required at this time in order to begin the scheduling process. This will be applied to the first month’s tuition. Your tuition amount will be emailed along with your student’s schedule approximately one week before the first lesson, at which time the remainder of your first month's tuition will be due. If we are unable to schedule you based on the availability information provided herein (and where applicable, in subsequent communication), we will be in touch to discuss alternative options, and if no suitable lesson time can be scheduled after that, the down payment will be returned.
Please choose payment method (your child cannot be scheduled without this information)
(Required)
Check (please mail TODAY payable to GRSM 9109 Dickey Drive, Mechanicsville VA 23116)
Credit Card
Credit Card Info
(Required)
Please use card already on file
I will complete the form linked below IMMEDIATELY and email it to info@grsm.net or fax it to 866-357-0239
Click Here For Credit Card Form
Please choose payment frequency
(Required)
In full up front
Half up front, remainder before start of second semester (School Year only).
Equal monthly payments due 1st of each month
Are you a new family?
(Required)
Yes (add $25 registration fee)
No (already paid $25 registration fee)
Discounts
25% off each student in a semi-private lesson
20% off additional sibling(s) in the same group
10% off tuition for third (or more) child
5% off tuition for second child or instrument (in a separate lesson)
Gift Certificate
Gift Certificate # (REQUIRED for redemption)
How did you hear about GRSM?
(Required)
