All links between students and teachers of the MusicLink program
require registration through the MusicLink Foundation.
OFFICE USE ONLY
S:
T:
SC:

This MusicLink Registration Form is for teachers who are not currently registered as MusicLink teachers and who have a student they wish to teach at a reduced fee (50% or more).

Please note: You will only be able to register one student from this page. To register additional students, you will need to sign in which requires an I.D. number. Submit this form and a MusicLink representative will contact you with your I.D. number.

If you are a registered MusicLink teacher currently teaching a MusicLink student and you wish to register additional students, click HERE.

1. STUDENT INFORMATION
First Name:      Last Name:
Age:    Grade:   Date of Birth:   Gender:   
Ethnic Origin:    Other: 

2. PARENT OR GUARDIAN INFORMATION
First Name:   Last Name: 
Address: 
City:    State/Province:   ZIP/Postal Code:
Home Phone:   Work Phone:   Cell Phone:
E-Mail: 
E-Mail 2: 

3. TEACHER INFORMATION
First Name:   Last Name: 
Address: 
City:    State/Province:   ZIP/Postal Code:
Home Phone:   Work Phone:   Cell Phone:
E-Mail: 
E-Mail 2: 
Teaching Experience: years. You began teaching in what year?

 
Instruments you teach:
 Baritone    Bass (Electric)    Bass (String)    Bassoon    Cello  
 Clarinet    Composition    Drums    Early Childhood    Euphonium  
 Flute    Guitar    Harp    Horn    Keyboard  
 Low Brass    Marimba    Music Appreciation    Oboe    Organ  
 Percussion    Piano    Recorder    Rhythm Class    Saxophone  
 Theory    Trombone    Trumpet    Tuba    Ukulele  
 Viola    Violin    Voice  
  Other Instruments: 
  Memberships: 
 MTNA    NFMC    MENC    ASTA    NATS  
 IAJE    ASOL    NGCSA    DCC    SAA  
Other: 
  Certifications: 
Background: 
Education: 
 Associates    Bachelors    Masters    Doctorate    Diploma  

Do you teach online lessons? 


4. LINK INFORMATION
Instrument:
Lesson Type:  Private    Group    Early Childhood   

Would you like us to check the financial eligibility of this family? 

If no, please provide some explanation of why you feel this student should be included in the MusicLink program:

 

5. SCHOLARSHIP INFORMATION

This information is required to assist in establishing the overall scholarship donation of our teachers to the MusicLink program. This information, which is used for statistical purposes, is kept strictly confidential:
Lesson Frequency     Length (minutes):
Normal fee charged per lesson: $    MusicLink fee charged per lesson:  $
Other Financial Arrangements:
 

6. ADDITIONAL ACTIVITIES
Computer Lab Frequency     Length (minutes):
Performance Class Frequency     Length (minutes):
Recital Frequency
 Other Activities:

Should we send our MusicLink newsletter to your student? 


7. TEACHER AGREEMENT

I understand that the MusicLink Foundation assumes no legal responsibility for claims arising from this instruction, and I agree to hold harmless MusicLink Foundation from all legal claims in connection with such instruction.

I agree:

PLEASE NOTE: The safety of our students is of utmost importance to us, so in volunteering to teach a MusicLink student please understand that you will be asked to submit to a background check at our expense. The MusicLink Foundation is required to obtain background checks on all of its teachers. The information we request to complete the background check will be kept strictly confidential and will be destroyed as soon as the background check is completed.

Our Assistant Director, Andrea Shore, will be contacting you to obtain your date of birth and social security number for the background check. Please note that she will be calling from her personal phone, so the caller I.D. will not say MusicLink. Feel free to ask her for your MusicLink I.D. number which you will receive on the following screen once you submit this form, so you can be assured that she is indeed from MusicLink.

If you prefer to call this information in yourself, please call the National Office at 703-534-9490. If you would like to mail the information, click HERE for a hard copy form.

If you have any questions or concerns, contact us at info@musiclinkfoundation.org.




Please click only once.
This may take several seconds.