Private Lesson Registration

Private Lesson Request Form

Welcome to Mattix Music Studio! Request a lesson time and we will contact you with specific days and times that are available. Students will be contacted in the order that registrations are received. We are only able to offer in-studio lessons at this time.
What type of student are you?

Returning studentNew student aged 3-18New adult student
Contact Information
Student 1 Name*

First NameLast Name
Student 1 Birth Date*

MonthDayYear
Student 1 Gender
Are you a Grand Avenue Preschool or After Care student?

YesNo
Student 2 Name (if applicable)

First NameLast Name
Student 2 Birth Date

MonthDayYear
Student 2 Gender
Are you a Grand Avenue Preschool or After Care student?

YesNo
Student 3 Name (if applicable)

First NameLast Name
Student 3 Birth Date

MonthDayYear
Student 3 Gender
Parent/Caregiver #1 Name*

First NameLast Name
Parent #1 E-mail*
example@example.com
Parent #1 Cell Phone*
Parent/Caregiver #2 Name

First NameLast Name
Parent #2 Email
example@example.com
Parent #2 Cell Phone
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState

Zip Code
How did you hear about us?*

I've done your classes before.Current family referralGoogle searchGrand Avenue PreschoolSocial mediaSchool teacherSpecial eventOther
What kind of instrument do you have at home, if any?*
Keyboard, upright piano, rental violin, etc.
Instrument & Method Choice
Student 1 Instrument*

PianoViolinViolaVoice
Student 1 Method Choice*

Suzuki MethodTraditional Method (if you're not specifically Suzuki, then you're Traditional)Not sure, tell me more
Student 2 Instrument (if applicable)

PianoViolinViolaVoice
Student 2 Method Choice

Suzuki MethodTraditional Method (if you're not specifically Suzuki, then you're Traditional)Not sure, tell me more
Student 3 Instrument (if applicable)

PianoViolinViolaVoice
Student 3 Method Choice

Suzuki MethodTraditional Method (if you're not specifically Suzuki, then you're Traditional)Not sure, tell me more
Scheduling
When would you like to begin private lessons?*
Right away, school year, next month, etc.
Specific Lesson Days & Times You Prefer - List as many options as possible.*
How should we contact you for lesson scheduling?*

TextEmailPhone
Anything else we need to know?

Details help us to place you in the best time and with the best teacher for your student. Personality types, learning styles, IEP's and other considerations are helpful and always confidential.
Additional Comments or Questions
Payment & Policies

Your first tuition payment is due when you agree to a lesson time. You will be emailed an invoice for your first month's tuition, music books and fees.
I will pay tuition and fees*

Monthly automatic charge to my credit card3% discount for paying by check for the entire school year
I agree to the Tuition Rates, Studio Policy and Terms & Conditions.*

Clear
Signed By*

First NameLast Name
Should be Empty:

Private Lesson Request Form

Contact Information

Instrument & Method Choice

Scheduling

Anything else we need to know?

Payment & Policies