Miracle Project Scholarship Registration Form

Name *

First

Last

Grade

Date of Birth

Gender

School

Address

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Guardian's Name

Guardian's Email *

Guardian's Address

Address Line 1

Address Line 2

City

State

Zip Code

Which Session would you like to participate in?

Miracle Project® Fall Session
Miracle Project® Spring Session
Miracle Project® April Vacation Session

Signature

I understand that regular attendance at Miracle Project® sessions is extremely important to get the most out of both the individual and group experience.

Emergency Contact Name *

First

Last

Cell Phone

Home Phone / Cell phone #2

Student Heath Concerns

Please give a brief description of any sensory needs we should be aware of or anything else you would like to share.

Ethnicity: This information is voluntary, however it helps secure much needed funding for the school, including our robust financial aid program. All information is completely confidential and reported out in number only. Please indicate all that apply for you or your child:

Please check sessions for which you are applying for a scholarship

Miracle Project® Fall SessionTuition $350.00
Miracle Project® Spring Session Tuition $350.00
Miracle Project® Vacation Camp Tuition $350.00

I need financial assistance, I am able to pay $________/month

The Music School shares photos, videos, and audio of our students through printed materials, website and social media to share the story of our mission, and encourage more people to become part of the Music School Family.

I give permission for my child’s/my photo, video or sound recording to be used by MCMS.
I do not give permission for my child’s/my photo, video or sound recording to be used by MCMS.

Signature of Parent/Guardian or Student (must be at least 18)

Manchester Community Music School

Miracle Project Scholarship Registration Form

Questions?

Explore our Lessons & Classes

Connect with MCMS

Quicklinks

Our Mission

Changing lives through the power of learning, sharing and making music.

Donate Your Used Vehicle