Please fill in your name.
Student Name
Is this student a minor?
Yes
No
Please fill in their birth date.
Please enter a valid date in the format (mm/dd/yyyy).
Student's date of birth:
Please fill in the parent/guardian name.
Parent/Guardian's Name
You indicated for us to contact you via phone. Please fill in your phone number.
Phone
You indicated for us to contact you via email. Please fill in your email address.
Please provide a valid email address.
Email
Please let us know how we should follow up with you.
How do you prefer for us to follow up with you?
Email
Phone
Please select a topic that you are contacting us about:
Where are our locations?
Please select a topic that you are contacting us about:
Donations
General
Germantown Branch Lessons & Classes
Kaleidoscope Preschool
Kardon Center for Arts Therapy
Kardon-Northeast Branch Lessons & Classes
Mary Louise Curtis Branch Lessons & Classes
Partnership Inquiries
Settlement Music Online
Willow Grove Branch Lessons & Classes
Wynnefield Branch Lessons & Classes
Please give us some info on what you need to know.
The Recommendation must be 500 characters or less.
What would you like to ask/tell us?
* (If you indicated telephone as the followup method, please let us know when is a good time to call!)
How did you hear about us?
I am a former student
Internet Search
Pass Building/Neighborhood
Received a Mailing
Saw a digital ad
Saw a Print Ad
Social Media
Student's School
Word of Mouth
Other...
You've indicated 'Other' for how you heard of us. Please enter a few words to elaborate on this.