USC Music Academy Student Registration Form

Primary Parent/Guardian Contact Information

If registering a child please include primary parent/guardian information.
Name

First NameLast Name
Relationship to Student
Mother, Father, Legal Guardian Etc.
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Email
example@example.com

Secondary Parent/Guardian Contact Information

If registering a child and where possible please include secondary parent/guardian contact information.
Name

First NameLast Name
Relationship to Student
Mother, Father, Legal Guardian Etc.
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email
example@example.com
Should be Empty: