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Volunteer Opportunities
 Dance Helpers at Pineloch Elementary
 Dance Helpers at Pineloch Elementary
 Dance Helpers at Pineloch Elementary
 Dance Helpers at Pineloch Elementary
 Dance Helpers at Pineloch Elementary

School of the Arts

School of the Arts Private Instruction Placement List Request

New students wishing to register for private instruction must submit their request on this form. Because of the demand for private instruction, all new private students are placed exclusively from this list and lessons are offered in order based on the date the request was made. Please submit a separate request for each student and/or instrument. Private students must be at least 7 years old. Please note that individual instructors may have further age restrictions. It is the responsibility of the student to notify the office of any contact information changes. If the student is over the age of 18, please enter the student's phone numbers and email address (parent's name is not required.)

Parent Information
Parent First Name:
Parent Last Name:
Home Phone Number:
Cell Phone Number:
Email Address:
Student Information
Student First Name:
Student Last Name:
Age:
Grade:
Gender: Male      Female
Check if student is home-schooled
Registration Information
Instrument:
Prior Experience:
Has an Instrument for Class: Yes      No
© 2008 St. Luke's United Methodist Church
Central Campus: 4851 S. Apopka-Vineland Road • Orlando, FL 32819
HopeSpring Campus (Sundays only): Bridgewater Middle School • 5600 Tiny Road • Winter Garden, FL 34787
Phone: (407) 876-4991 • Fax: (407) 876-6495
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