Music Lessons Inquiry

Music Lessons Inquiry

What music instruction are you looking for?
Student's Full Name

First NameLast Name
Student's Birthdate

MonthDayYear
Date
What instrument does the student want to learn?
Has the student ever had instruction in this instrument?

NoYes
If "yes", please describe previous instruction:
Why does the student want to learn this instrument? What style of music would they like to play? Are there any specific songs they would like to learn?
Name of Contact Person (Parent or Guardian, etc)

First NameLast Name
Contact Number
Please enter a valid phone number.
Email Address
example@example.com
What weekly time would work best for you?

Monday 1-3pmMonday 3-5pmMonday 5-7pmTuesday 1-3pmTuesday 3-5pmTuesday 5-7pmWednesday 1-3pmWednesday 3-5pmWednesday 5-7pmThursday 1-3pmThursday 3-5pmThursday 5-7pmFriday 1-3pmFriday 3-5pmFriday 5-7pmSaturday 10am-12pmSaturday 12-2pmSaturday 2-4pm
Please note that we may not have immediate availability for your preferred instrument and time.

If that's the case, we will put you on a waitlist and let you know when we have an instructor available.
Should be Empty: