MELODY Piano Student Application
All K-12 students interested in learning piano and who have a financial need and are invited to apply! Learn more about us at
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Parent/Guardian Contact Info
Parent/guardian's name *
Parent/guardian's email address *
Parent/guardian's phone number *
Parent/guardian's preferred language *
Student Info
Student's name *
Student's email address *
Student's age and grade level *
Student's school *
Briefly tell us about yourself! How would you describe your personality? What are your favorite subjects at school? What are your hobbies and interests? *
Help us get to know you and match you with a teacher!
Musical background
Please be detailed so we can match you to the best teacher for your needs!
What is your piano level? *
Describe your piano experience. Have you taken group or private lessons in piano before? *
We don't expect you to have very much or any at all – we just want to get a sense for your experience so we can find a teacher for you!
Do you have experience playing any other instruments? Have you taken group or private lessons for these instruments before? *
 We don't expect you to; we just want to learn more about your background!
Why are you interested in MELODY piano lessons? *
What kind of music do you like or hope to play? Any specific songs or pieces? *
Additional Info
Does your family have a piano or electric keyboard at home? *
This is NOT a requirement for lessons.
Are you able to commit to practicing piano regularly? *
Is there anything you'd like us to know?
About you, why you want to learn music, or anything we can do to make you a successful musician
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