Piano & Double Bass Lessons Registration
Please complete all the required details below. (To be completed by the parent/guardian if under the age of 18). The information you provide here will form the basis of your consultation lesson and will be used after you enrol to track your progress. When you have completed your form, sign at the bottom of this page and click to submit. You will be automatically redirected to book your consultation lesson. All your data is secure, encrypted and in compliance with GDPR.
Student Details
Name
*
First Name
Last Name
Date of birth
*
-
Day
-
Month
Year
Date
Email
*
example@example.com
Phone Number
*
-
Country Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have any medical conditions which I should be aware of, or anything which could affect your ability to participate in instrumental lessons safely online? (If yes please give details)
*
Parent/Guardian Contact
Required if student is under 18 years old
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Country Code
Phone Number
Student Questionnaire
Please select which instrument(s) you are registering for:
*
Piano
Double Bass
Do you have regular access to an instrument and a suitable setup for online lessons?
*
Yes
No
Are you classically trained on your instrument?
*
Yes
No
Can you read music to at least a basic fluency level?
*
Yes
No
Have you passed Grade 5 theory or do you have theory knowledge at an equivalent level or above?
*
Yes
No
What is your current level of proficiency on your instrument?
*
State grade level or equivalent
Do you currently have lessons with another teacher? (Please give details)
*
How long have you been learning your instrument?
*
Have you had online instrumental lessons during Covid-19 or prior to now?
*
Yes
No
Are you prepared to commit to regular lessons and practice?
*
Yes
No
What performance experience have you had on your instrument?
*
What performance goals would you love to work towards?
*
What are your biggest achievements on your instrument so far?
*
What currently are your biggest challenges in performance/in your lessons in general?
*
What do you love most about playing your instrument?
*
Do you have any specific queries or concerns about online lessons? (Please give details)
Signature
*
Parent/guardian signature if under 18 years old
Thank you for taking the time to complete this form. When you click below you will be automatically redirected to my booking page to schedule your consultation lesson.
Submit
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