SCHOOL OF AMERICAN MUSIC FORMS

Michiana’s Musical Connection

SCHOOL OF AMERICAN MUSIC FORMS

Michiana’s Musical Connection

School of American Music Forms

Click on the form name below to fill it out.

Music Class Enrollment Form - Sign Up for Music Lessons

School of American Music Class Enrollment Form

Last Name

Address

Primary Phone

Email:

Emergency Contact (Under 18)

Emergency Contact Phone/Cell

First Name

City/St/Zip

Alternate Phone

Relationship

Check if Student is affiliated with:

Berrien Springs Parent Partnership

Niles Public Schools

Home Schooled

Public or Parochial School

Adult

Course

Teacher

Start Date

Photo/Video Release: By signing this form, I authorize the School of American Music to use or publish any photographs/videos taken of me or my child/children to promote classes on the website and other publicity now and in the future.

Release And Waiver Of Liability and Indemnity Agreement: By signing this form, I release the School of American Music and its officers, agents and employees from all liability to the undersigned (and from any minor participants for whom the undersigned has the capacity to contract), thereby releasing indemnifying, and holding harmless the School of American Music, its officers, agents, and employees from all liability to the undersigned (and to said minors) for any loss or damage on account of physical, mental and emotional injury to the undersigned (of said minors) caused by the School of American Music, its officers, agents and employees. I am releasing as it applies to myself and to any minor for whom I am signing.

Payment Options:

PayPal

Checks made out to the School of American Music at first lesson.

Scholarships are generally offered as 25% or 50%

In this extraordinarily difficult time, we are offering scholarships up to 100% based on need.

SCHOLARSHIPS are awarded for 10-week sessions on a percentage basis. One scholarship is available for each student for each 10-week session. The Scholarship Fund is supported by donations and by fees paid for performances by student/faculty musicians. Please indicate the tuition amount you can pay towards the cost of the lessons. Scholarships are available to students who make progress in the program.

In this extraordinarily difficult time, we are offering scholarships up to 100% based on need.

Absence/No Show/Cancellation: I agree to give notice of absenteeism directly to the teacher by phone or email at least 24 hours in advance.

I Agreement to Terms stated above.

Yes

Parent or guardian signature if participant is under 18 years of age.

Signature (Type in Name)

Signature Date

Ron Spears Guitar Class Enrollment Form (Summer)

Twitter
Ron Spears Guitar Class Enrollment Form
5 Lessons - $100
Last Name

Address

Primary Phone

Email:

Emergency Contact (Under 18)

Emergency Contact Phone/Cell

First Name

City/St/Zip

Alternate Phone

Relationship

Check if Student is affiliated with:
Berrien Springs Parent Partnership
Niles Public Schools
Home Schooled
Public or Parochial School
Adult
Course

Teacher

Start Date

Photo/Video Release: By signing this form, I authorize the School of American Music to use or publish any photographs/videos taken of me or my child/children to promote classes on the website and other publicity now and in the future.
Release And Waiver Of Liability and Indemnity Agreement: By signing this form, I release the School of American Music and its officers, agents and employees from all liability to the undersigned (and from any minor participants for whom the undersigned has the capacity to contract), thereby releasing indemnifying, and holding harmless the School of American Music, its officers, agents, and employees from all liability to the undersigned (and to said minors) for any loss or damage on account of physical, mental and emotional injury to the undersigned (of said minors) caused by the School of American Music, its officers, agents and employees. I am releasing as it applies to myself and to any minor for whom I am signing.
Payment Options:

PayPal

Checks made out to the School of American Music at first lesson.

Scholarships are generally offered as 25% or 50%

In this extraordinarily difficult time, we are offering scholarships up to 100% based on need.
SCHOLARSHIPS are awarded for 10-week sessions on a percentage basis. One scholarship is available for each student for each 10-week session. The Scholarship Fund is supported by donations and by fees paid for performances by student/faculty musicians. Please indicate the tuition amount you can pay towards the cost of the lessons. Scholarships are available to students who make progress in the program.
In this extraordinarily difficult time, we are offering scholarships up to 100% based on need.
Absence/No Show/Cancellation: I agree to give notice of absenteeism directly to the teacher by phone or email at least 24 hours in advance.
I Agreement to Terms stated above.
Yes
Parent or guardian signature if participant is under 18 years of age.
Signature (Type in Name)

Signature Date

Suzuki Sampler Enrollment Form

Email
Suzuki Sampler
6 Lessons - $120
Last Name

Address

Primary Phone

Email:

Emergency Contact (Under 18)

Emergency Contact Phone/Cell

First Name

City/St/Zip

Alternate Phone

Relationship

Check if Student is affiliated with:
Berrien Springs Parent Partnership
Niles Public Schools
Home Schooled
Public or Parochial School
Adult
Course

Teacher

Start Date

Photo/Video Release: By signing this form, I authorize the School of American Music to use or publish any photographs/videos taken of me or my child/children to promote classes on the website and other publicity now and in the future.
Release And Waiver Of Liability and Indemnity Agreement: By signing this form, I release the School of American Music and its officers, agents and employees from all liability to the undersigned (and from any minor participants for whom the undersigned has the capacity to contract), thereby releasing indemnifying, and holding harmless the School of American Music, its officers, agents, and employees from all liability to the undersigned (and to said minors) for any loss or damage on account of physical, mental and emotional injury to the undersigned (of said minors) caused by the School of American Music, its officers, agents and employees. I am releasing as it applies to myself and to any minor for whom I am signing.
Payment Options:

PayPal

Checks made out to the School of American Music at first lesson.

Scholarships are generally offered as 25% or 50%

In this extraordinarily difficult time, we are offering scholarships up to 100% based on need.
SCHOLARSHIPS are awarded for 10-week sessions on a percentage basis. One scholarship is available for each student for each 10-week session. The Scholarship Fund is supported by donations and by fees paid for performances by student/faculty musicians. Please indicate the tuition amount you can pay towards the cost of the lessons. Scholarships are available to students who make progress in the program.
In this extraordinarily difficult time, we are offering scholarships up to 100% based on need.
Absence/No Show/Cancellation: I agree to give notice of absenteeism directly to the teacher by phone or email at least 24 hours in advance.
I Agreement to Terms stated above.
Yes
Parent or guardian signature if participant is under 18 years of age.
Signature (Type in Name)

Signature Date

Arts & Education Center Rental Form

Company
Arts and Education Center Event Rental Form
The A&E Center can be rented for events. Fill out this form and deliver, with advance payment, to Donna Mitchell via SchoolOfAmericanMusic@gmail.com or mailed to: 3 North Elm St, Three Oaks, MI 49128
Date of Event

Event Time

Event Description

Setup Needs
Rental Fee (1 hour minimum)
Rate Entity
$50/hr General rate, foundation-funded
$35/hr Local business
$25/hr Local non-profit organization
$25/hr Local individual, family
Rental Fee

Hours

Total
Total:

Last Name

Address

Primary Phone

First Name

City/St/Zip

Email:

Payment Payment is to be made in advance by: (a) cash, or check made out to School of American Music and delivered to Donna Mitchell; or, (b) by PayPal using the SAM website.
Reduced rental rate are available in certain circumstances. To apply, fill out the form: Application for Waiver of Facility or Equipment Rental Fee
Release And Waiver Of Liability and Indemnity Agreement:
In consideration for, and as a condition of, the use of this facility, the renter shall:
hold harmless the Three Oaks Arts & Education Center (A&E Center) and the School of American Music (SAM), its officers, agents and employees, against any claims, demands, damages, costs and liabilities, resulting from or caused by the renter’s use of the facility;
defend, at its sole expense, any suits, actions, or legal proceedings that may arise from or relate to the renter’s use of the facility;
pay for any damage, or loss by theft of any property of A&E Center and SAM, done or caused by renter its agents and invitees.
AGREED
I Agreement to Terms stated above.
Yes
Signature (Type in Name)

Signature Date

SAM Scholarship Application

Phone
Application for SAM Tuition Scholarship
Fill out this form and deliver it to Donna Mitchell via SchoolOfAmericanMusic@gmail.com or mailed to: 3 North Elm St, Three Oaks, MI 49128
Date

Student/Attendee Name

Parent Name (if applicant is under the age of 18)

Last Name

Address

Primary Phone

First Name

City/St/Zip

Email:

Cost of Lessons
Duration Cost
10 weeks/45-55 minutes $260
5 weeks/45 minute lessons $130
10 weeks/30 minute lessons $220
5 weeks/45 minute lessons $110
Scholarship Amount Requested

Amount of Tuition Student/Attendee Will Pay

TOTAL COST OF CLASS/WORKSHOP
Total:

SCHOLARSHIPS are awarded for 10-week sessions on a percentage basis. One scholarship is available for each student for each 10 week session. The Scholarship Fund is supported by donations and by fees paid for performances by student/faculty musicians. Please indicate the tuition amount you can pay toward the cost of the lessons. Scholarships are available to students who make progress in the program.

We are raising funds to provide scholarships up to 100% of the cost of lessons.

In this extraordinarily difficult time, we are offering scholarships up to 100% based on need.

The information provided is a true and accurate reflection of my need for a student scholarship. I grant permission to photograph/video the student’s participation in our music/education sessions.
Payment Payment is to be made in advance by: (a) cash, or check made out to School of American Music and delivered to Donna Mitchell; or, (b) by PayPal using the SAM website.
AGREED
I Agreement to Terms stated above.
Yes
Signature (Type in Name)

Signature Date

Recording Studio Rental Form

Web Site
Application to Rent the A& E Center
for Audio Recording/Mixing
The A&E Center can be rented for recording or mixing. Fill out this form and deliver, with advance payment, to Donna Mitchell via SchoolOfAmericanMusic@gmail.com or mailed to: 3 North Elm St, Three Oaks, MI 49128
Date of Event

Event Time

Event Description

Setup Needs
Rental Fee (1 hour minimum)
Rate Entity
$50/hr General rate, foundation-funded
$30/hr Local business, family individual
Rental Fee

Hours

Total
Total:

Last Name

Address

Primary Phone

First Name

City/St/Zip

Email:

Payment Payment is to be made in advance by: (a) cash, or check made out to School of American Music and delivered to Donna Mitchell; or, (b) by PayPal using the SAM website.
Reduced rental rate are available in certain circumstances. To apply, fill out the form: Application for Waiver of Facility or Equipment Rental Fee
Release And Waiver Of Liability and Indemnity Agreement:
In consideration for, and as a condition of, the use of this facility, the renter shall:
hold harmless the Three Oaks Arts & Education Center (A&E Center) and the School of American Music (SAM), its officers, agents and employees, against any claims, demands, damages, costs and liabilities, resulting from or caused by the renter’s use of the facility;
defend, at its sole expense, any suits, actions, or legal proceedings that may arise from or relate to the renter’s use of the facility;
pay for any damage, or loss by theft of any property of A&E Center and SAM, done or caused by renter its agents and invitees.
AGREED
I Agreement to Terms stated above.
Yes
Signature (Type in Name)

Signature Date

Rental Fee (1 hour minimum)
Rate	Entity
$50/hr	General rate, foundation-funded
$35/hr	Local business
$25/hr	Local non-profit organization
$25/hr	Local individual, family

Cost of Lessons
Duration	Cost
10 weeks/45-55 minutes	$260
5 weeks/45 minute lessons	$130
10 weeks/30 minute lessons	$220
5 weeks/45 minute lessons	$110

Rental Fee (1 hour minimum)
Rate	Entity
$50/hr	General rate, foundation-funded
$30/hr	Local business, family individual

Download Forms
If you would like to download the form in WORD or PDF format click the links below.

SAM Music Class Enrollment Form (.DOCx)
SAM Music Class Enrollment Form (.PDF)
Arts & Education Rental Form (.Docx)
Arts & Education Rental Form (.PDF)
SAM Scholarship Application Form (.DOCx)
SAM Scholarship Application Form (.PDF)
Recording Studio Form (.DOCx)
Recording Studio Form (.PDF)

Scholarships

We are raising funds to provide scholarships up to 100% of the cost of lessons.
In this extraordinarily difficult time, we are offering scholarships up to 100% based on need.
Scholarships are awarded for 10-week sessions on a percentage basis. One scholarship is available for each student for each 10-week session. The Scholarship Fund is supported by donations and by fees paid for performances by student/faculty musicians. Please indicate the tuition amount you can pay toward the cost of the lessons. Scholarships are available to students who make progress in the program.

Payment Options

Lessons
A & E Center Facility Rental
Recording Studio
MIsc. Payment for Lessons
Pay for Lessons
You have the following options:
10 lessons of 30-40 minutes each $220.00
10 lessons of 45-55 minutes each $260.00
5 lessons of 30-40 minutes each $110.00
5 lessons of 45-50 minutes each $130.00
5 lessons – Ron Spears Guitar Class – $100
6 lessons – Suzuki Sampler – $120

Class Payments
Student Name
Instrument/Teacher

Arts & Education Center Rental fee

Rates

Recording Studio Deposit
Make a deposit on the recording studio time. There will be additional fees for an A&E certified recording engineer to assist in the sesson.

Rates

Use this form to pay for non-standard rate lessons.

Class Payments
Student Name
Instrument/Teacher

CONTACT US

Today

CONSIDER A TAX DEDUCTIBLE DONATION
To support the arts in the Michiana Region

Donate

SCHOOL OF AMERICAN MUSIC FORMS

Michiana’s Musical Connection

SCHOOL OF AMERICAN MUSIC FORMS

Michiana’s Musical Connection

School of American Music Forms

Music Class Enrollment Form - Sign Up for Music Lessons

School of American Music Class Enrollment Form

Ron Spears Guitar Class Enrollment Form (Summer)

Ron Spears Guitar Class Enrollment Form

Suzuki Sampler Enrollment Form

Suzuki Sampler

Arts & Education Center Rental Form

Arts and Education Center Event Rental Form

Total:

AGREED

SAM Scholarship Application

Application for SAM Tuition Scholarship

Total:

AGREED

Recording Studio Rental Form

Application to Rent the A& E Center
for Audio Recording/Mixing

Total:

AGREED

Download Forms

Scholarships

Payment Options

Pay for Lessons

Arts & Education Center Rental fee

Recording Studio Deposit

Use this form to pay for non-standard rate lessons.

CONTACT US

CONSIDER A TAX DEDUCTIBLE DONATION

Maps

Donate

Contact Us

Register

SCHOOL OF AMERICAN MUSIC FORMS

Michiana’s Musical Connection

SCHOOL OF AMERICAN MUSIC FORMS

Michiana’s Musical Connection

School of American Music Forms

Music Class Enrollment Form - Sign Up for Music Lessons

School of American Music Class Enrollment Form

Ron Spears Guitar Class Enrollment Form (Summer)

Ron Spears Guitar Class Enrollment Form

Suzuki Sampler Enrollment Form

Suzuki Sampler

Arts & Education Center Rental Form

Arts and Education Center Event Rental Form

Total:

AGREED

SAM Scholarship Application

Application for SAM Tuition Scholarship

Total:

AGREED

Recording Studio Rental Form

Application to Rent the A& E Center for Audio Recording/Mixing

Total:

AGREED

Download Forms

Scholarships

Payment Options

Pay for Lessons

Arts & Education Center Rental fee

Recording Studio Deposit

Use this form to pay for non-standard rate lessons.

CONTACT US

CONSIDER A TAX DEDUCTIBLE DONATION

Maps

Donate

Contact Us

Register

Application to Rent the A& E Center
for Audio Recording/Mixing