Withdrawal Form

Thank you for your patronage and the opportunity to share music with your family.
Please complete the form below and you’ll be emailed a confirmation of your final lesson & billing dates.
Please note that withdrawal form must be received by the close of business on the 15th in order to meet the deadline for the next billing cycle.

    Email Address:

    Reason for withdrawal:

    Will student attend remaining lessons?

    Does student plan to resume lessons in the future?


    Acknowledgement of withdrawal policy