Preparatory and Public Programs Request for Information

Thank you for your interest in Preparatory and Public Programs at CIM!

Please complete the form below. Upon submission, you will receive an email with additional information about the student's selected programs.

* Denotes a Required Field

Student First Name*

Student Last Name*

Primary Contact Email Address*

Student Primary Phone Number

Is this student a child or adult?*

Student Date of Birth*

Grade Entering Fall 2022*:

Current School Student is Attending

Parent/Guardian First Name*

Parent/Guardian Last Name*

Parent/Guardian Email Address*

Parent/Guardian Phone Number

Mailing Address

Country

Street

City

Region

Postal Code

Desired Entry Term*

Primary Instrument/Area of Study*:

Secondary Instrument/Area of Study (optional):

Please select all the programs you are interested in*:

The Academy at CIM

Musical Pathway Fellowship

Private Lessons Summer 2022 (children and adults)

Private Lessons Fall 2022 (adults only)

Youth Program - Traditional Track

Young Artist Program

Young Composers Program (Summer)

How did you hear about CIM Prep?*

Please Describe*: