Request for Lessons
At CocoSounds
* Required
Students name
*
This is a required question
Students Phone Number
This is a required question
Parents name (if under 16 years)
This is a required question
Parents Phone Number
This is a required question
Email Address
*
This will be used for Invoices
This is a required question
Postal Address
*
This is a required question
Students Age
*
This is a required question
I would like to learn
*
Singing
Piano
Guitar
Bass Guitar
Drum Kit
Hand Drum
Brass
Song Writing Assistance
Music Theory
This is a required question
Do you have a preference for a teacher?
*
This will also be determined by the instrument you choose.
Stella Savy
Anna Billbourough
Barry Deenick
Holly DeJong
Geoffrey Williams
Harrison Dale
Imogen Dale
Mary Card
Oliver Kay
Paige Duggan
Any
This is a required question
Do you have a preferred time?
*
Monday after School/ Business Hours
Tuesday after School/ Business Hours
Wednesday after School/ Business Hours
Thursday after School/ Business Hours
Friday after School/ Business Hours
Saturday Morning
Not really sure, need to discuss with Teacher
Other:
This is a required question
Would you like your lesson...
*
1/2 hour weekly
1/2 hour fortnightly
1 hour weekly
1 hour fortnightly
Once Off
Other:
This is a required question
Does the student have any experience?
This is a required question
Where did you hear about us?
*
Friend
Google
CocoSounds website
Facebook
Boite
At a gig?
StellaSavy.com
Other:
This is a required question
Never submit passwords through Google Forms.