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Lesson preferences
Please complete the following questions regarding your preferences for your lesson.
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* Indicates required question
Name of Student
*
Your answer
Name of Parent/ Legal Guardian
*
Your answer
Best phone number(s) at which to contact you.
*
Your answer
Best email(s) at which to contact you.
*
Your answer
What lesson length are you requesting?
*
30 minutes
45 minutes
60 minutes
Preference for location
*
At the home of Erik Allesee in Lawrenceville
At your own home (I understand there is an additional fee of $5.00 per lesson for this service.)
Preference for Day of the Week (may check more than one)
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Required
Preferred time(s). Please list as many as possible, or a time frame.
*
Your answer
By initialing below, I certify that I agree to the terms of the contract.
*
Your answer
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