Prospective Student Questionnaire
Parent's Email Address *
Student's Email Address
Student's Name *
Parents' Names
(if applicable)
Address *
City *
Zip *
Parent's Phone *
Student's Phone
Age *
e.g. Yorktown Middle School, Grafton High School, Homeschooled, etc.
(if applicable)
Birthdate *
What are your personal goals regarding piano proficiency? *
Number of months/years previous piano training *
Type of previous instruction *
Do you (the student) play any other musical instruments? *
If yes, please specify
Other Musical Training/Experience *
Choirs, school/church productions, etc.
As best as you can, please evaluate your (the student's) current musical proficiency. *
Can he/she play a few songs, read notes, play two hands, etc.
How would you describe your (the student's) learning style? *
Any food allergies or pertinent medical conditions? *
On what kind of Instrument will you be practicing? *
Where did you hear about Noble Piano Studio?
Google, website, personal referral, etc.
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