Triton College - School of Continuing Education Children's Music Lessons - Waiting List (708) 456-0300, Ext. 3500

Please provide the student information on this waiting list form.
*Required Information
*First Name:
Middle Initial:
*Last Name:
*Birthdate: (age range 5-15)
*Phone Number: ex:999-999-9999
*Email Address:
*Instrument for lessons :
Does student have a sibling(s) on this wait list?	Yes No
If yes, please provide the sibling's name(s):
*Parent/Guardian Name:
Comments:
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