New Private Lesson Student Questionnaire
Interested in Private Music Lessons at CSMA?

Please complete this questionnaire to be added to our prospective student list. Please be as specific and detailed as possible. The information you provide will help us match you with a teacher. Once lessons are confirmed, we will provide a copy to your teacher to help him/her understand your needs and plan your lessons.

Private lesson enrollment begins approximately one month prior to the start of the semester and continues after the semester has begun.

Please fill out one questionnaire per student.

Questions? Please contact Kathryn Sanwick, CSMA Private Lessons Coordinator at (650) 917-6800 ext. 330 or ksanwick@arts4all.org.

Parent's first and last name (if applicable)
Adult students may enter N/A
Your answer
Student's first name
Your answer
Student's last name
Your answer
Student's birthdate
Please note the correct year as it is helpful for determining a student's age.
MM
/
DD
/
YYYY
Starting semester
Instrument/voice
Please visit our website for a list of options: http://arts4all.org/music-school/private-music-lessons/instruments
Your answer
Home address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Home phone
Your answer
Mobile phone
Your answer
Email address
Your answer
Preferred method of contact?
You may select more than one option.
Required
Please select:
Has the student had any previous music instruction? If yes, please provide details of the student’s music background and experience.
Your answer
Please tell us about the student: personality, learning styles, interests, etc.
Your answer
What qualities are you looking for in a private lesson teacher?
Your answer
Does anyone else in your family play a musical instrument? If yes, please describe.
Your answer
If the student has studied this instrument before, what books have they used? What pieces have they studied most recently?
Your answer
Our teachers require daily practice. Is the student prepared to make this commitment?
Your answer
What are the student’s musical goals? Check all that apply.
Required
Would you like to sit in on your child’s lessons?
Do you already have a suitable instrument at home for daily practice?
Does the student have any learning disabilities or special needs?
Providing this information can be very helpful for teachers as they develop a learning plan for the student.
Your answer
Please list your schedule preferences.
More flexibility allows us to provide more options with various teachers.
Your answer
CSMA recommends studying music theory as a supplement to private lessons. Would you like to learn more about our comprehensive Music Theory Program?
Submit
Never submit passwords through Google Forms.
This form was created inside of Community School of Music and Arts. Report Abuse - Terms of Service - Additional Terms