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2018-2019 Episcopal Piano Enrollment Form
Thank you for your interest in the Piano Program. Students will have a one on one lesson each week for a total of 15 lessons per semester with one of our four teachers. Teacher assignments will be based on availability and order of registration.
The following information includes the cost for your child's lessons: Kindergarten through 2nd Grade, $600 per semester. 3rd Grade and up, $750 per semester. Also, every student is charged a once yearly “studio fee” of $45 in addition to their first semester lesson charge.


Please answer each question as fully as you can.

Email address *
Full name of Student (include middle name and nicknames) *
Your answer
Student Birthday *
Your answer
Rising Grade for 2018-2019 *
Please provide the name of the best adult to contact regarding this student. *
Your answer
Home or cell phone *
Your answer
Has this student had piano lessons before? If so, who was their previous piano teacher? *
Your answer
If you answered yes above, how many years has the student been in piano lessons, and at what age/grade did the student start lessons?
Your answer
To enroll in piano, you must own an 88-key weighted keyboard with damper pedal or an acoustic piano. Please indicate which you have. *
Your answer
Has anyone else in the family had music lessons, and would they be able to help the student practice at home? *
Your answer
Would you like to be billed for the whole semester at once, or have the tuition split into monthly payments? *
Registration for piano is for the entire year. Are you willing to commit your child to piano lessons for the entire year, and in the event you wish to withdraw from the program, will you continue with your financial obligation until another student can be found to fill the lesson slot? *
Please indicate any activities that might conflict with piano scheduling (e.g. tutoring during school hours, any after school activity that prevents a lesson at the end of the day, etc.) Please indicate the days and times of these activities. *
Your answer
If your child has tutoring, please provide their tutor's name and email/phone number so that we can coordinate our scheduling. *
Your answer
For Lower School students, lesson scheduling uses one of the daily PE slots as the first choice. Only in the event of overflow are lessons scheduled during foreign language. Please indicate that you understand lessons are scheduled during PE. *
Required
5th grade students can also be scheduled during homeroom from 2:50-3:20. Please mark which days your 5th grade student is available during homeroom. *
Required
Middle School students are scheduled on Monday, Tuesday, Thursday, and Friday, during the 9:10-9:50 time slot or the 2:45-3:15 time slot. Please let us know if you have a time preference (preferences cannot be guaranteed.)
Your answer
We believe that anything worth doing is worth doing well. As part of our piano program, we require students to establish a consistent practice routine (we encourage 5 days of practice a week). Please mark below, indicating that you commit to establishing a practice routine this year. Be prepared to help young (K-2nd grade) or beginning students practice daily, and be willing to remind your child to practice as needed. You will also need to check their practice assignment regularly to ensure that they are doing their entire assignment, including Theory or Workbook homework (written work). *
Please enter any other comments you might have or helpful tips regarding your child. Things to include would be student learning challenges, experiences with a previous piano teacher that worked/didn't work, or special musical interests the student might have (for example, learning jazz or Broadway music).
Your answer
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