UNI Suzuki School Registration Form 15-16
Student Name:
This top portion to be completed by parent for students still in
high school or younger:
instrument:
Student’s birth date
Grade
Mother/Father parent #1 name:
Parent #1 address:
If different than student’s
Parent #1 home phone
If different than student’s
at School
Home or billing address:
City
ZIP:
Parent #1 work phone:
Home phone:
* New student - T-shirt size ADULT s m l xl
Parent #1 employer:
YOUTH s m l
Parent #1 email:
Parent’s Email:
Parent cell phone:
Student’s email:
Mother/Father Parent #2 name:
Announcements and bulletins will be sent via email to these
addresses unless you specify differently or write NO EMAIL in the
space above.
Parent #2 address:
If different than student’s
Parent #2 home phone
If different than student’s
IMPORTANT:
The following section must be completed for group or chamber
music assignment consideration for all students. If the student is a
beginner (one who has not had any lessons), skip this section. If
not a beginner but a first time registrant, please complete as much
information as possible so we can assess the student’s correct
placement. Pre –Twinklers—students- not yet in book 1-- should
put PT as current piece.
Parent #2 work phone:
Parent #2 employer:
Parent #2 email:
Parent #2 cell phone:
In addition to the email address listed on the left, also email
bulletins to this email address:
Current Suzuki piece:
Suzuki book #
List any supplementary books used in lessons
Are you currently renting a UNI Suzuki instrument?
__NO __YES If so, please list number on case_________
Scale book used
Working in Theory Time Vol. #______
Student also receives music instruction on the following:
Student is interested in enrolling or in more information about the
following:
_____NIJO audition (grades 5 – 8) Fee $145 (annual)
_____NIYO audition (grades 9 – 12) Fee $145 (annual)
_____ Fiddlesticks audition (violin students in book 5+)
_____Quartet or chamber ensemble audition
(must be able to read music) Students will be placed in ensemble
based on reading level. There is an extra fee for this activity. Price
depends on number of meetings.
_____ violin/viola beginner package (ages 3 – 6)
_____ Suzuki Package (individual & group lesson)
_____ Suzuki Package (no group—
by director permission only in advance semester)
REQUIRED FIELDS: All -- Put NA if not applicable
PARKING TAG ORDER: $31.80 each ____ NO TAG this year
I have enclosed ________ (separate check payable to UNI) for
____ Suzuki visitor parking tag(s). DO NOT INCLUDE registration,
instructional or rental fees with parking fee check. This tag is for 1
year and allows parking in specific UNI lots---before 4:00 on
weekdays in Schindler Lot and after 4:00 in Russell Hall lot. There
are no restrictions on the weekends. Suzuki tags may also be
used in the metered lot by GBPAC for Suzuki events at Gallagher
Bluedorn when lot is available.
NOTE: Contact information will be shared with the teacher,
director, group parent and volunteer coordinator.
If requesting a change of teacher, please use a separate piece of
paper to note your request.
To complete registration process:
Complete Registration, Scheduling, Signature & Volunteer forms.
Mail to:
UNI Suzuki School
University of Northern Iowa
Cedar Falls, IA 50614-0246
by August 10 for fall or as soon as possible for mid-year
applications. Information received by the deadline will receive
priority. Payment of the $125 registration fee can be included
with the form or paid at fall registration on August 22.
* Newly enrolled students will be given a free t-shirt.
SCHEDULING INFO:
Please indicate this student’s
CHILD’S NAME: ___________________________________
Spring, 2015 individual lesson teacher___________________
& Summer, 2015 lesson teacher
___________________
GROUP LESSONS: All students will be placed in a group based on the piece listed on the registration form. There is only one group per
level and no scheduling options are available for group. It is suggested you make a copy of this page for your records and notify
cathy.craig@uni.edu if you want to change or add information prior to registration day.
GENERAL SCHEDULING INFORMATION: Teacher will honor your preferences, if possible.
What is the earliest time you can arrive at UNI for lessons after school? At __________ on most week days.
What is the latest time you would consider a lesson? Ending at _________________ on most week days
For preschool or home schooled, do you prefer morning or afternoons before 3:00? (circle preference)
Do you have a preferred day of the week? Specify______ Do you have a preferred time of day? specify________
Any other scheduling considerations?
TIME
7:30 AM
8:00
8:30
9:00
9:30
10:00
10:30
11:00
11:30
12:00 NOON
12:30
1:00 PM
1:30
2:00
2:30
3:00
3:30
4:00
4:30
5:00
5:30
6:00
6:30
7:00
7:30
8:00
8:30
MON
TUE
WED
THU
FRI
SAT
PLEASE READ
Leave BLANK all possible times you can come for
lessons and put an X in those times you are not
available. Be sure to include early morning, lunch
hour or Saturday times if that works for you. Please
offer as many scheduling options as you can.
PLEASE DO NOT DELAY IN RETURNING THIS FORM:
If you have some times in question or are waiting to
hear the scheduling of other activities, please fill in
your schedule with a "?" in those times and return
your form as soon as possible.
IMPORTANT NOTE: Please consider your entire
school year schedule when providing scheduling
information. Teachers prefer to keep their
schedules set for the year and may not be able to
reschedule lessons due to seasonal sports or other
extracurricular activities. Also, students not offering
enough scheduling options may not be considered
for enrollment
LESSON LENGTH REQUESTED
30 min.
45 min.
60 min.
GRADE IN SCHOOL__________
ALL INFO DUE BY AUGUST 10 so teachers can
organize their schedules before registration day
even though you may have already discussed the
lesson times with your teacher. We may need your
schedule to work out group times.
If you have other children who take lessons from another UNI Suzuki School teacher, please list student name(s) and teacher name(s) :
________________________________________________________________________
NOTE: The above scheduling info will be used to schedule your child’s individual lesson. If you requested that your child also be considered
for a chamber music group, this info will be used for that scheduling also.
Current and potential NIJO & NIYO students: Please X-out Fridays 5:00 -7:00 on the above schedule.
From our policy statement: Enrollment must be made for the full academic year or from date of enrollment until the last week of the
spring session. Early withdrawal requires director approval and an early withdrawal fee.
When you provide a check as payment, you authorize us either to use information from your check to make a one-time electronic fund transfer from your
account or to process the payment as a check transaction. When we use information from your check to make an electronic fund transfer, funds may be
withdrawn from your account as soon as the same day the payment is received and you will not receive your check back from your financial institution.
MAIL TO: UNI Suzuki School, University of Northern Iowa, Cedar Falls, IA 50614-0246 before August 10, 2014.