The Jam Factory Inquiry Form

The Jam Factory is looking for 6 students who are ready to rock! Please fill out the form entirely to be considered. If your student is chosen, we will reach out to discuss payment details :)
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.
Student Name*

First NameLast Name
Student Birth Date*

MonthDayYear
Does your child have experience in any of the following?*

GuitarBassKeyboard/PianoDrumsVocalsNoneOther (please explain below)
If indicated "other" above, please explain further here:
Preferred Day for Private Lesson (would be at 5:45pm or 6:30pm)*

MondayTuesday
Please ask your student why they would like to be part of our program and input their response below:*
Should be Empty:

The Jam Factory is looking for 6 students who are ready to rock! Please fill out the form entirely to be considered. If your student is chosen, we will reach out to discuss payment details :)