JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Sign Up For Music Lessons with Mason Music Foundation
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Parent's First Name (if applicable)
Your answer
Parent's Last Name (if applicable)
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Student's Birthday
*
MM
/
DD
/
YYYY
What school do you or your child attend?
*
If you're out of school, just type Adult.
Your answer
Instrument
*
Guitar
Piano
Voice
Drums
Violin
Bass
Mandolin
Banjo
Ukulele
Required
Do you have an instrument in working order for at-home practice?
If you have an instrument but aren't sure if it's in good shape, mark "maybe."
Yes
No
Maybe
Clear selection
Describe your current skill level:
First Time
Beginner
Intermediate
Advanced
Clear selection
What are your goals with music lessons?
Select all that apply.
I want to play or sing for my own enjoyment.
I want to study music in school.
I want to play or sing publicly, but just for fun.
I want to become a professional musician, songwriter, or recording artist.
Other:
What kind of music do you want to learn?
Click all that apply. If you're not sure, just tell us what you like to listen to.
Alternative Rock
Bluegrass
Blues
Broadway
Classic Rock
Classical
Country
Heavy Metal
Hip Hop
Jazz
Pop
Worship
Other:
Who are your favorite artists/bands/composers?
Your answer
List 3 adjectives to describe the personality of the student. Things like: outgoing, shy, serious, funny, diligent, laid back, etc.
This will help us match you with the best fit teacher.
Your answer
How did you hear about us?
*
Check all that apply.
Word of Mouth
Drive By
Internet Search
Social Media
Advertisement
Community Event
Online/Radio/TV Ads
Mailer
Other:
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mason Music.
Does this form look suspicious?
Report
Forms