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Music Lesson Intake Form
Please complete this form before booking your first lesson. It will greatly assist the instructor in customizing your musical adventure.
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* Indicates required question
Student's full name
*
Your answer
Email (of parent or guardian if student is under 18)
*
Your answer
Phone (of parent or guardian if student is under 18)
Your answer
Student's address
*
Your answer
Student's age
*
Your answer
Student's availability (day and time)
*
Your answer
Student's gender/preferred pronouns
Your answer
Desired lesson frequency
*
Weekly
Bi-weekly
Area(s) of focus
*
Piano
Music Production
Piano & Music Production
What are the student's musical goals?
Your answer
Skill Level
*
Total Beginner (0-12 months of experience)
1
2
3
4
5
6
7
8
9
10
Highly Skilled (10+ years of experience)
Estimated amount of weekly practice time
An hour or less
1-3 hours
3 or more hours
Clear selection
Desired number of lesson-hours
*
4 (use within 2 months)
12 (use within 6 months)
24 (use within 12 months)
Anything else you'd like to share?
Your answer
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