mfMusic Studio Registration - Adult
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Email address
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Your email
I am registering for:
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45 Min Voice Lessons - in studio
1 Hour Voice Lessons - in studio
45 Min Piano Lessons - in studio
1 Hour Piano Lessons - in studio
1 Hour Combination Piano and Voice Lessons - in studio
45 Min Piano Lessons - in home
1 Hour Piano Lessons - in home
45 Min Voice Lessons - virtual/online
1 Hour Voice Lessons -- virtual/online
45 Min Piano Lessons - virtual/online
1 Hour Piano Lessons -- virtual/online
Name
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Your answer
Age
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18 - 25 years old
26 - 35 years old
35 - 49 years old
50 - 65 years old
66+ years old
Occupation
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Your answer
Home Address
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Your answer
Mobile Phone Number
Your answer
Home Phone Number
Your answer
Which form of communication do you most prefer?
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Email
Text cell phone
Call cell phone
Call Home Number
In case of an emergency, who should I contact? Please list name and phone number
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Your answer
What type of instrument will you be using for home practice?
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Acoustic, baby grand piano
Acoustic, upright
Digital piano with weighted keys
Electric keyboard
I do not own a keyboard instrument
Other:
Describe your previous music background.
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Your answer
Are you currently studying another music instrument? If so, please describe.
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Your answer
What are your goals for taking lessons?
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Your answer
What styles of music do you listen to most?
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Classical
Pop/Rock
Country
R & B
Christian Rock
Musical Theater
Other:
Required
Is there any type of music you would prefer not to study?
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Your answer
I plan to pay for tuition in the following way:
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One lesson only for now - Trial Lesson
Punch Card Option 4 45-min lessons (daytime only)
Punch Card Option 4 60-min lessons (daytime only)
Punch Card Option 12 45-min lessons (daytime only)
Punch Card Option 12 60-min lessons (daytime only)
Full Tuition for the year in ONE payment
Tuition for the year in TWO equal payments
Tuition for the year in TEN equal payments, due by the 7th of each month
By typing my name and date below, I am electronically signing this document to indicate that I have read the full mfMusicStudio Policy at
www.mfmusicstudio.com/about-the-studio
and agree to abide by the terms listed in the policy.
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Your answer
(This is optional) By typing my name and date below, I am electronically signing this document to grant Margaret Fontiveros the right to take photographs or videos of my family in connection with any mfMusic Studio event. I authorize Margaret Fontiveros to use and publish the same in print and/or electronically. I agree that Margaret Fontiveros may use such photographs/videos of us with or without our names and for any lawful purpose, including for example such purposes as web content or Facebook newsfeed. .
Your answer
Send me a copy of my responses.
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