Notice of Student Discontinuation

The student described in this form has paused or terminated their instruction at Holy Names Music Center. The form will be emailed to the office once you press submit.

Teacher Name(required)

Student Name(required)

On what day did the student tell you they were discontinuing lessons?(required)

Why is the student discontinuing lessons?(required)

On what day did or will the final lesson occur?(required)

Per the discontinuation policy, the student may be charged for up to two (2) additional lessons after they give notice of discontinuation, which they should have the option to make use of when possible. To allow for varying circumstances, charging the student for two weeks notice is done at the teacher's discretion and should be included in the current month time sheet dates and listed below if you choose to bill for it. In your time sheet, mark student absences as 'unexcused'.

Enter all lesson dates you will bill for current month (+ any not recorded during year that should have been):(required)