Vacation

The Mobile Music Teachers LLC policies for temporary withdrawal from lessons are as follows:

1. Student must give Mobile Music Teachers LLC 30 days notice for temporary withdrawal from any or all lessons received. No exceptions. Notice must be given in the form of this Vacation Form. Verbal withdrawals between the student and teacher will not be accepted.
2. If the student fails to give a 30 day notice of temporary withdrawal from lessons, the student is obligated to pay the normal tuition fee for an additional month following the date on the official Vacation Form.
3. We cannot guarantee that the student's original lesson day/time will be available when student resumes lessons.

Student's Name

Guardian's Name

Home Phone

Cell Phone

Work Phone

Email

Current Address

City, State

Zip Code

Teacher's Name

Instrument Being Taught

Please check the month(s) when lessons will NOT be received
JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

I will resume lessons the month of
---JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Compliments (Optional)

Concerns (Optional)

I have read and understand the Vacation policies above. I hereby authorize the temporary withdrawal of the student(s) from their lessons with Mobile Music Teachers LLC. By typing my name below, I authorize the verification of the information provided on this form as correct.

Signature of Student (or Guardian if student is under 18)

Date (mm/dd/yyyy)