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Senior Piano Lesson Interest Form
The Haywood County Arts Council is sponsoring a piano class for adults, age 55 and older, wishing to learn to play the piano. The class will run for five weeks, and the next session starts in early 2017. These lessons are ideal for older adults that may have taken (or wished they had taken) piano lessons as children. Students are invited to learn in a no-stress environment, with small classes of 2-4 people only. The cost for the five classes is $60, plus a materials fee for a music book (less than $20).

Please answer the following questions, and we will be in touch! Thank you for your interest.

First Name
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Last Name
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Street Address
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City
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State
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Zip Code
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Phone Number(s)
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Email Address
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Have you ever taken piano lessons before?
If yes, when and for how long did you play?
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Do you play, or have you ever played, another musical instrument?
If you play/have played another instrument, which instrument and for how long?
Your answer
Would you classify your piano playing level as absolute beginner, beginner or advanced beginner?
Do you own or have convenient access to a piano or electronic keyboard?
Are you involved in any music groups (singing or instrumental) at the present time? If so, what group?
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Other comments/questions/information:
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