Banks Bridgewater Lewis
Fine Arts Academy
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Lesson & Ensemble Registration
Please fill out the form below to register for private lessons and/or ensemble.
Private lessons can be one-on-one or in a small group.
Performing ensemble is the jazz band or jazz combo that performs in the community and recitals.
A member of our teaching staff will be in contact regarding your form. Thank you for your interest!
Payment options are listed on the bottom of this application.
Lessons Ensembles Registration
Student First Name
Student Last Name
Grade & Age
Student Email
Student Phone
Address
Street address
Address
City, Zip Code
Desired or Current Instrument
Years of Experience
0-1 Years
2-3 Years
4 or more years
Has your scholar taken lessons before? If so, please indicate below.
Parent/Guardian Name
Parent/Guardian Phone
Parent/Guardian Email
Parent/Guardian (2) Name
Parent/Guardian (2) Email
Parent/Guardian (2)Phone
Payment for:
Individual/Small Group Lesson
Ensemble (School Year)
Ensemble (Semester)
Special Activities or Workshops
Please choose payment option:
Paypal via BBL website
Check
Cash
Scholarship Request
Verification code
Teaching Staff
Nathaniel C. Banks
nabanks2@icloud.com
Ron Bridgewater
rbridgew@icloud.com
Robert Lewis
robertelewis803@att.net
Deborah Banks
kayebanks@gmail.com
Abby Heras
abbyheras@gmail.com
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