Piano Lessons Application Form

Itsuko Bara and Bart Kenis Piano Studio

Please fill out the form below to be placed on our waiting list.
Student Name*

First NameLast Name
Birth Date*

MonthDayYear
Parent Name *

First NameLast Name
Phone Number —— You will be contacted via text massage.*
Please enter a valid phone number.
Email*
example@example.com
What is your postcode?*
Please choose a time slot from below*

30 minutes ($70)45 minutes ($105)60 minutes ( $140)
How did you hear about us ?*

A referral/friendSuzuki websiteIBBK piano studio websiteOther
If you answered 'a referral or friend', can you please share their name?
Do you have an acoustic piano at home?*

Yes.No but I am going to purchase before starting lessons.
If yes,what kind of piano?
Message to us.
For waiting list students

Applications are entered onto our database in order in which they are received. When a space becomes available, you will be contacted to have a meeting with us. We will arrange the time for our meeting to have a small chat.
Studio Policy
https://www.itsukobara-bartkenis-pianostudio.com/studio-policy
Should be Empty:

Itsuko Bara and Bart Kenis Piano Studio