Interest Form
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Email *
Student Name *
Student Age (If under 18) *
Student Pronouns *
Guardian(s) Name (if student is under 18 years old)
Guardian(s) Prounouns
 Secondary Email
Phone
Preferred Method of Contact *
I am interested in... *
Required
I would like to do lessons... *
Required
Days available for lessons *
Required
Times available for lessons (All times listed in EST) *
Required
Please include any further scheduling information that might be helpful. If there is a specific day/time that works best please include that information.
I am interested in... *
Required
Pricing option interested in
Clear selection
Why do you want to take lessons? *
How did you hear about me? *
I understand that we will use Zoom for lessons and Venmo for payment of lessons. I will submit the $25 payment before the Meet & Greet session. (Venmo information included in the confirmation email.) *
A copy of your responses will be emailed to the address you provided.
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