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Get DePauw University Student Registration Form

Rs: Current Instructor (if any): Medical Concerns/Allergies (if any): Emergency Contact: Parent Information Name (please print): Address (if different than above): City: State: Home Phone: Work Phone: Cell Phone: Zip: Email: Length of lesson you wish to sign up for Fee per lesson $ The $25.00 registration fee plus payment for one class must be made payable to DePauw University and submitted with this registration form. The balance should be paid directly to the instru.

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