New Student Form

This form needs to be filled out by all new students who plan to take lessons with TeJay Rogers. Please fill in all required fields. Please do not fill out this form if you are not the parent or a student of TeJay Rogers.

Student's Name*
First Last
Guardian's Name*
First Last
Email*
Phone*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Special notes:
Please add any important information about this student (e.g. custody issues, special needs, allergies, etc)
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