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Lesson preferences
Please complete the following questions regarding your preferences for your lesson.
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Name of Student *
Name of Parent/ Legal Guardian *
Best phone number(s) at which to contact you. *
Best email(s) at which to contact you. *
What lesson length are you requesting? *
Preference for location *
Preference for Day of the Week (may check more than one) *
Required
Preferred time(s). Please list as many as possible, or a time frame.

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By initialing below, I certify that I agree to the terms of the contract. *
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