Daniel Knowles Vocal Studio 971 N. La Cienega Blvd. #209 Los Angeles CA 90069 (310) 772-9984
Student Information

Today’s Date ____________________

Name     _______________________________________________

Guardian/Agent Name_____________________________________

Address ________________________________________________

              ________________________________________________
 
              ________________________________________________                                                  

Phones: Please supply at least one phone number. 
              Place a check next to the phone number as the one I should try first.                     
                     
Home    (_________)______________________________________

Cell       (_________)______________________________________

Other     (_________)______________________________________

Work*   (_________)______________________________________

E-Mail    ________________________________________________

*Used only if you want me to contact you at the “last minute” to cancel etc.  
  and you would like to be called at work to be sure you get the message.

Comments/Notes:

(rev7/02)