Carla Breaux’s Piano Studio
6603 Meadow Ridge Lane
Lake Charles, LA 70605
337.884.6389
Registration Form
2024-2025
Registration Fee: $100. Please make checks out to "Carla Breaux"
Due by August 5, 2024. Your time slot is not guaranteed until the registration fee is paid.
Students’ Name: __________________________
Students’ Age & Birthday: ______________
Grade: _____________
Parents’ Name: ___________________________
Address :_____________________
_____________________
Home Phone : _____________
Cell Phone : ____________
Email: ___________________________
Students’ Interests: _________________________________
Please list 3 different day and different time slots which will fit into your schedule.
1.__________________
2.__________________
3.__________________
Lessons will begin on September 2, 2024.