Enroll a Student

Please fill out the application below. If you have any questions regarding the application, please contact Jennifer Clark at JenC@swflmusic.org

Applicant's First and Last Name(Required)

First Last

Applican'ts Date of Birth(Required)

Contact Name (If different from applicant)

First Last

Phone Number(Required)

Email Address(Required)

Applying for:(Required)

Two-year High-School Transition Program

Four-year Music Certificate

How did you hear about the Southwest Florida Music Education Center?(Required)

Please describe the applicant's musical interests, experiences, or talents:(Required)

Please list of the applicant's diagnoses, including neurological, intellectual, developmental, mental, and/or related to mental health.(Required)

What instrument(s) does the applicant play?(Required)