APPLICATION FOR ATTENDANCE

Rock School
10903 NE 53rd Street
Kirkland, WA 98033
(425) 828-3232
www.rock-school.org

Student Name:
Student Email:
Student Phone:
Parent/Guardian Name(s):
Parent/Guardian Email:
Parent/Guardian Phone:
Address:
Address Line 2:
City:
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Zip:
School:
Grade:
Age:
What instrument(s) does the student currently play?	Guitar Bass Drums Vocals
Experience that the student has in the instrument(s) chosen:
What style(s) of music is the student interested in?
What classes would the student be interested in taking? Keep in mind that not all classes are offered through every program. Click here to read about what each program has to offer. If you're applying for the Rock Seattle Summer Camp, please pick one instrument and two supplementary courses.	Instrument Courses Guitar - Beginning Guitar - Intermediate Guitar - Advanced Bass - Beginning Bass - Intermediate Bass - Advanced Drums - Beginning Drums - Intermediate Drums - Advanced Supplementary Courses Band 101 (school year only) Recording Vocals/Songwriting Additional Summer Camp Supplementary Courses Live Sound (summer camp only) Music Art (summer camp only)
Which program is the student interested in?	Rock School Seattle - The Center School (after school - October - June) Rock School Seattle - Youngstown (after school) opening in January 2008 Rock School Maple Valley (after school - October - June) Rock School Kirkland (after school - Ocotber - June) Rock Seattle Summer Camp
If there aren't any openings in the program of your choice, would you consider having the student attend the alternate program?	Yes No

Rock School is a local non-profit corporation. All information that you provide will be kept private and only shared with Rock School staff, otherwise with your permission. Click button to submit.