Adult Student Registration

Adult Student Registration Form
First Name*
Last Name*
Full Name
Email*
Mobile*
Format: 0000000000.
Home Phone
Format: 00 0000 0000.
Phone Number
Please enter a valid phone number.Format: +61000000000.
Phone to pass to Monday
Teacher StudioMy homeEither
Address

Street Address

Street Address Line 2

SuburbState / Province

Post Code
Preferred Teacher / Location
If you have a specific teacher or studio location in mind, please let us know. Otherwise please let us know the suburb where you live or work and we will advise the closest teacher.
Preferred Teacher
If you have a specific teacher in mind, please let us know.
Do you have a piano or keyboard at home where you can practice?
YesNoMaybe
What is your current grade level in AMEB Piano
Preferred days / times for lessons
Please briefly describe your musical background, including any previous training in piano, other instruments, or voice
How did you hear about Melbourne Piano School?
Other - please specify
Who referred you?
What are you interested in working on at the lessons? (Click as many as apply)
What are you interested TO PASS TO MONDAY
Anything else you'd like to share
Yes
Pref Teacher
Should be Empty:

Adult Student Registration Form