If your child has special needs, please let us know. We would like to serve you and your family to the best of our abilities, and it is very important to understand the children we teach. This information would be held in strictest confidence: __________

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Please help us with marketing by letting us know how you heard about KINDERMUSIK at THE BURCH SCHOOL?

____ Kindermusik Web Site

____ Burch School Web Site

____ The Schoolhouse

____ Newspaper (Which:_________________________________________________)

____ Southwestern Bell Yellow Pages

____ Word of mouth (Who:______________________________________________)

____ Other: ___________________________________________________________

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BRING A FRIEND DISCOUNT:

($5 off tuition for every new family recruited to Kindermusik…up to four families for a total of $20 off)

I am new to the Burch School and was recruited by: _____________________________

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I am returning to the Burch School and have recruited:___________________________

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