PreRegistration Form

Student Information
Student Name *
Student Name
mm-dd-yyyy
Is Prospective Student Under the Age of 18? *
Guardian Name
Guardian Name
Required if prospective student is under age 18.
Parent, Grandparent, Etc.
Contact Information
Address *
Address
Primary Phone *
Primary Phone
How do you prefer follow up from Settlement?
Area of Study
Please indicate particular instrument for individual study, or classes/ensembles/etc. in which the student is interested in pursuing at Settlement.
If known
Survey Information
How did you hear about Settlement?
Please select all that apply