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Adult Group Piano Class
Please complete this form for class interest. The instructor will contact you with information about the class.
First Name
Last name *
Address *
Phone *
Best email contact *
I give permission for for pictures or name of participant to be used for publicity in publications such as, but not limited to, newsletters, newspapers and magazines, and WIU brochures. *
I agree and will abide by the WIU Covid protocols as described on this link - http://www.wiu.edu/vpas/risk_management_and_emergency_preparedness/coronavirus/index.php *
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