MUSIC LESSON
REGISTRATION FORM
Instrument(s) student would like to learn:
VOICE
PIANO
VIOLIN
GUITAR
UKULELE
SONGWRITING
MUSIC THEORY
OTHER
Lesson Duration Preference
30 Minutes
45 Minutes
60 Minutes
Lesson Location Preference
ONLINE
IN PERSON
HOUSE VISIT (minimum value $100/visit)
Student's Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Allergies
List as many as you need, and put an X beside if deadly
Parent(s) / Guardian(s)
Email
Phone Number
Previous Experience
Additional Notes / things that I should know about the student (if any)
Submit
Should be Empty: