New Student Form

New Student Form

For Music Lessons With Leah
Name

First NameLast Name
Second Student Name (if applicable for the same family)

First NameLast Name
Parent Name (If Applicable)

First NameLast Name
Parent #2 Name (If Applicable)

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent #1 Phone Number
Please enter a valid phone number.
Parent #2 Phone Number
Please enter a valid phone number.
What kind of music lessons are you interested in?

PianoGuitarVoiceAudition PreparationMusic Theory/Music FundamentalsWorship Coaching
What length of lesson would you prefer?

30 minutes45 minutes60 minutes
Select your preferred payment methods

CashCheckApple PayVenmo
In-Person Music Lesson Rates:
***10% discount available for payment made every 3 months & 20% discount available for payment every 6 months***

$35/30 minutes

$50/45 minutes

$70/60 minutes

Online Music Lesson Rates:

$30/30 minutes

$45/45 minutes

$60/60 minutes
How do you plan to pay for lessons?
How would you like to have lessons?

In-PersonOnline (FaceTime or Zoom)
How did you find me?
If you found me from a referral, please type the name of the person who referred you.
Is there anything I should know about you and your goals and dreams with music? The more information you can provide, the more helpful it is for me to plan out your lessons. (Please include if you have previous music experience, favorite artists/bands/songs you would like to learn, etc.,)
I understand that payment for music lessons is required up front (monthly or quarterly).

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