Intent Form 2018–2019

Student’s Information

Select your season 2017–2018 MYAC Ensemble:

Select your season 2017–2018 Instrument:

Student’s First Name:
Student’s Last Name:
Student Cell Phone:
Home Phone:
Family E-mail:
Student E-mail:
Address:
City, State ZIP:,
Student’s Birthday (mm/dd/yy):(e.g. 10/15/12)
Parent 1 Name:
Parent 1 Employer:
Parent 1 Cell Phone:
Parent 2 Name:
Parent 2 Employer:
Parent 2 Cell Phone:


Intent to Participate

Please indicate whether you plan to participate in MYAC during the 2018 - 2019 Season.

Withdrawal reason:


You must complete an Intent Form AND submit a $100 non-refundable tuition deposit (below) to hold your spot.
Intent forms and deposits are due by April 17, 2018.

Note: If you need to register multiple students, please complete an online Intent Form for each student.


School Music Program

Students participating in MYAC programs are required to participate in their school music program. Please provide information pertaining to your participation in school music programs:

Academic School you attend:
School Program name:
School Program Director:


Private Teacher Information

Please provide information pertaining to your private music study:

Private Teacher:
Private Teacher Phone:
Private Teacher E-mail:


Join the MYAC Volunteer Team!

Volunteerism thrives at MYAC and allows us to offer exceptional performance and concert opportunities! From assisting with seating auditions to designing benefit invitations or directing traffic at Bass Fest and Viola Fest, volunteers perform important services to enhance our overall programs. MYAC's Volunteer Coordinator, Karen Dennis, will be emailing you weekly "Volunteer Sign-ups" with news and information about volunteer opportunities at MYAC. If you have any questions related to volunteering, feel free to email karendennis@mya.org

We could help with:



Photo Permission

Please indicate whether you give us permission to photograph your student during the 2018-2019 season.

Student Directory Permission

Please indicate whether you give us permission to include your phone number, email, and home address in any MYAC Student Directory during the 2018-2019 season.

Submit Your Form

Once you have verified that all of the above information is complete and accurate, please click the button below. Submitting this form with your $100 tuition deposit represents a commitment to participate in Midwest Young Artists Conservatory program(s) during the entire Season 2018-2019. MYAC will expect your enrollment in both fall and spring semesters and will not fill your place in your current ensemble with another student. The tuition deposit will be applied to your tuition invoice for the season as the final installment. The tuition deposit is neither refundable nor transferable should you change your enrollment plan for Season 2018-2019. Please review Your Responsibilities as an MYAC Member and confirm that you understand your responsibilities, including paying your tuition bills.

Payment Information

You may reserve your student's spot in his or her existing ensemble by paying a $100 non-refundable tuition deposit. The non-refundable tuition deposit must be paid by April 17, 2018. You may make a secure, on-line payment in the amount of $100 as soon as you submit this form, or you may mail or bring in a check to the office. Payment must be made in full.

Midwest Young Artist Conservatory
878 Lyster Road
Highwood, IL 60040

Please note: Financial assistance is available.