Let us know about you!
Fill out as much information as you can in preparation for your phone consultation. Once you have submitted this form you will receive a call within 24 hours.
Email *
Your answer
First Name *
Student
Your answer
Last name *
Student
Your answer
Parent/Guardian First & Last Name *
Only if different from Student, Otherwise use N/A
Your answer
Phone Number *
This is the number we will use for your consultation, payments, scheduling, etc...
Your answer
Additional Phone Number
Optional
Your answer
Physical Address *
Remember our lessons are done in the comfort of your home. Please be specific with a complete address including City State and Zip. You may also choose an alternate location for your lessons that is not a home residence.
Your answer
Billing Address
If different from physical address
Your answer
What instrument are you looking to learn? *
Your playing experience *
Tell us about yourself, give a short description of your experience, why you want to continue your education, what motivates you, how long you have been playing, etc... This will help us with the matching of an instructor for your needs.
Your answer
What days do you prefer for your lessons *
Check all that apply
Required
What time of day do you prefer for your lesson *
Check all that apply
Required
When should we contact you for your consultation? *
Check all that apply (we will call the main phone number you left us above)
Required
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This form was created inside of Jam It Music Lessons.