2017-2018 New Student Registration
Hello! I'm so glad you're ready to start making music (again?).
Please fill out this form so I can find out more about you.
- Ms. Julia
Student's Full Name
Adult or Child?
Child 7 - 11
Teen 12 - 17
Adult 18 - 118
Prefer not to say
Parent/ Guardian Name (required for children and teens)
Relationship to Child
(mother, father, grandparent, guardian, etc.)
Please tell us a little bit about your music experience. Have you ever taken lessons? For how long? Have you ever performed music in front of an audience? Anything else you want me to know?
Music Goals- please check off any goals you have for your music learning
Play your favorite songs
Read music on paper
Perform in front of a crowd
Write your own songs
Explore music technology and recording
What styles of music are you interested in?
Christian Gospel or Contemporary
Musical Theatre and Show tunes
Are there any emotional or behavioral issues that we should be aware of before lessons begin?
If yes, please explain
After submitting this form you will hear back from me within 48 hours to chat more about your music goals and get you set up with lessons and/or classes.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service