Private Lesson Request Form
Welcome to the Private Class Request Form for The Music Place!

This form collects some basic registration information from you so that our enrollment team can find the best teachers and scheduling options available for your family, and also get to know you a little better. After we receive your answers, we'll follow up with you by email within a few business days, so keep an eye on your inbox for news from <info@musicplace.com>.

Should you require any assistance, please feel free to reach out to us by phone or email (see below), or come visit us in person during business hours.

Primary adult contact details
This section is intended to gather information about you (the parent/guardian or primary adult). There will be an option later on in the form to add children to your registration request.
First name *
You may include a preferred name in parenthesis after your first name.
Your answer
Last name *
Your answer
Email address *
Please use the same email address that is associated with your ClassMate (Pike13) account if you have one.
Your answer
Phone number *
This should be the best phone number to contact you. Format example: (408) 445-2787
Your answer
Zip code *
This is so we can find which locations are closest to you. For better accuracy, we suggest using your full Zip Code with the "plus 4" numbers at the end. For example: 95125-5561 instead of just 95125. If you don't know your full Zip Code, you can look it up here: https://tools.usps.com/zip-code-lookup.htm?byaddress
Your answer
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