2026-2027 Private Music Lesson Request

2026 - 2027 PRIVATE LESSON REQUEST
We look forward to seeing you!
We will be in contact with you shorly to arrange a lesson slot based on the information provided in this form. Please note, we are not able to guarantee the availability of any slot requested on this form.
Parent / Guardian #1 Name

First NameLast Name
Parent / Guardian #1 Email

Confirmation Emailexample@example.com
Parent / Guardian #1 Cell Phone
Was the student registered for 2025-2026 Private Lessons
Is student registered for 2026-2027 Youth Dance or Theater classes
Student Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
How you hear about us?

Other
Student Date of Birth

MonthDayYear
Student Birth Date

MonthDayYear
Gender Identity
Lesson Type (Select all that apply) Each lesson type selected is a separate lesson slot

Other

Preferred Days

Length of Lesson
Please let us know if you have a preferred teacher:
Additional comments or information you would like us to know: ex. any experience, earliest arrival time
Should be Empty:

2026 - 2027 PRIVATE LESSON REQUEST