2020 Piano Lesson Enrolment Form
Kimberly's Piano Room
Email address *
Do you agree to my 2020 Studio Policies? *
Have a read before you start filling out the form or else clicking the link may delete your answers! Please do read them as they include important information about next year's fees. https://pianoroom.nz/wordpress/wp-content/uploads/2019/12/2020-Studio-Policies-3.pdf
Student's Full Name *
Your answer
Student's Date of Birth *
MM
/
DD
/
YYYY
Parents'/Caregivers' Names *
Your answer
Phone Numbers *
Please specify who the numbers belong to
Your answer
Home Address *
Your answer
Any medical conditions or learning difficulties I need to be aware of:
Your answer
Student's previous/current musical education *
Your answer
Parents'/Caregivers' musical background *
Your answer
Why are you putting your child into piano lessons? *
Your answer
What would you like your child to achieve through piano lessons in 2020? *
Your answer
How much practice do you expect your child to be able to do during the week? *
Your answer
What kind of piano/keyboard do you have in your home? *
Your answer
How does your child feel about their 'buddy' situation? *
Please tick any times you would NOT be available for piano lessons in 2020
These are not exact lesson times, but are for me to see general times you would be available for lessons.
1:00
1:30
2:00
2:30
3:00
3:30
4:00
4:30
5:00
5:30
6:00
6:30
7:00
Mon
Tue
Wed
Thu
Fri
If I were to open up Saturday mornings, what would be your availability for that day? Tick any times you would NOT be available for lessons.
9:00
9:30
10:00
10:30
11:00
11:30
12:00
12:30
Sat
Any comments about lesson availability:
Your answer
What is the earliest time you could be at a lesson after school? *
Your answer
What is the latest time your child could finish their lesson? *
Your answer
What are your ideal lesson times/days? *
I cannot guarantee anything, but will do my best to accommodate as many preferences as possible
Your answer
Is there any other info that would be useful for me to know so that I can provide the best lessons possible for your child?
Your answer
Do you give permission for photos/videos taken in lessons to be shared for advertising purposes? *
There is a $35 registration fee due along with the form *
This is to hold your place in my schedule, and cover just a little bit of the work I do in January scheduling and planning for the year. My bank account details are on the Studio Policies document.
A copy of your responses will be emailed to the address you provided.
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