Music Students Registration

Welcome To Berryessa Music Boosters & Berryessa Art & Wine Festival

Music Classes Payment/Enrollment Form

Berryessa's Middle Schools and Elementary Schools Instrumental and Choral Musical Programs need participation from all parents/guardians.

A single payment of $120.00 per student is requested. Please send your check or money order payable to Berryess Music Boosters, Inc.

Optionally, payments may be made as three(3) payments of $40.00 per stdent, due on or before September 17, October 15 and November 15. Please mail checks to:

Berryessa Music Boosters, Inc.

1750 Swanston Way

San Jose, Ca. 95132

Or, they can be delivered to your child's music teacher.

If another payment option is required, please contact:

Zoa Fitch

(408) 923-3083

Music Students Registration

Student First Name :
Student Last Name :
Parent/Guardian First Name :
Parent/Guardian Last Name :
Student Grade Level :
Student Skill Level :
Student Instrument :
Borrow Instrument :
Parent/Guardian Email :	*
Parent/Guardian Address 1 :
Parent/Guardian Address 2 :
Parent/Guardian State :
Parent/Guardian Zip :
Parent/Guardian Day Phone :
School Attending :
Music Teacher First Name :
Music Teacher Last Name :

Music Instruction