Registration Form Page.1
        
        Press P to print out this form:
        
                              RON VAN HOOSE
                       Tuner - Technician - Author
                      4291 Holland Road,  Suite 534
                        Virginia Beach, VA  23452          
        
        
                         STUDENT REGISTRATION FORM
        
        Before  filling out this form, please read the file  STUDENT 
        INFORMATION.  Request this from the main menu.
        
        ____________________________________________________________
        PLEASE PRINT:
        
        NAME     ___________________________________________________
        
        ADDRESS  ___________________________________________________
        
        CITY     ________________________ STATE __________ ZIP _____
        
        ____________________________________________________________
        The  following  personal  information is  not  required  for 
        registration.  However, it may be helpful when corresponding 
        with you via telephone or audio tapes.
        
        FORMAL EDUCATION:  High School Graduate?  Yes ___ No ___
                           College Graduate?      Yes ___ No ___
                           Highest year completed 1 __ 2 __ 3 __
        
        College Major: _____________________________________________
        
        WHY DO YOU WANT TO LEARN TO SERVICE PIANOS?  _______________
        
        ____________________________________________________________
        
        ____________________________________________________________
        
        ANY PHYSICAL PROBLEMS WITH HEARING, ARM OR BACK - OTHER?
        
        ____________________________________________________________
        
        ____________________________________________________________
        
        HAVE YOU STUDIED PIANO TUNING BEFORE?  Yes ___ No ___
        If yes please explain:______________________________________
        
        ____________________________________________________________
        
        ANY MUSICAL TRAINING OR EXPERIENCE?    Yes ___ No ___ 
        If yes please explain: _____________________________________
        
        ____________________________________________________________







                                            Registration Form Page.2

        I  request  to  be registered in  the  Piano  Tuning  course 
        "STRICTLY TUNING".  My check or money order is enclosed  for 
        the items and/or services requested. (please no cash)
                                  
                                  *******
        Registration, Illustrations, and Audio tapes       $ 29.95
        
        Business/Repair Disk  Including all diagrams          FREE
       
        Disk size requested 5.25" [ ]  3.5" [ ]
        
        Basic Tool Kit (optional $30.00)                     _____
        
        Authorization for Technical Support via Audio         FREE
        Tapes (see submission cost in Student Infor-
        mation file)
        
        Course Examination/Grading/Certificate               _____
        (not required)  May request anytime within
        five years of registration ($15.00)
        
        AFTER Graduation - Telephone Support for              FREE
        One FULL year
        
        Shipping/handling:
        U.S. $3.00 - Canada/Mexico $8.00
                     ALL Other countries  $15.00             _____
        
        Total Enclosed - U.S. funds only                   $ _____
        
        ************************************************************
        I  understand there is a shipping/handling charge  for  each 
        submission of audio tapes and for the submission of the tape 
        for the final examination.
        
        ___________________________________        _________________
                 (student signature)                     (date)
        
        
        Registered:
        
        ___________________________________        _________________
                   Ron Van Hoose                         (date)
        ============================================================
        
        
        A signed copy of this form will be returned to you.