Please print this page from your browser and mail it with your tuition to:

Cumberland Valley School of Music
1015 Philadelphia Ave.
Chambersburg, PA 17201

CVSM Registration Form

Check if New CVSM Student

Name

 

Date of Birth

 

Parent'sName

 

Home Phone

 

Office Phone

 

E-Mail

 

Address

 

City, State Zip

 

Semester

 
Course/Instrument

Location

Day/Time

Teacher

Tuition

A.        
B.        
C.        
D.        

Addiional 3% of tuition if opting to

Fall Registration:

use payment plan.

    $25 Individual

 

$40 Family

 

Subtotal:

 

Spring (if not previously registered in Fall)

    $25 Individual $25 Family

Registration Fee:

 

Summer Registration (if not previously registered):  

    $10 Individual $15 Family

Total:

 

* The Annual Registration Fee is payable once per academic year (Fall - Summer)

                ________-________-________-________

Expiration Date ________    

Signature ____________________________________________

Check Enclosed

 

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Cumberland Valley School of Music  •  1015 Philadelphia Avenue, Chambersburg, PA 17201  •  (717) 261-1220