Student Application
Student's Name
Your answer
Your answer
Current School Grade
(if applicable)
Lesson Length Desired
Student’s Practice Instrument:
Has s/he previously taken any piano lessons?
If you answered "yes" to the above question, please list the piano books the student currently owns and indicate which books s/he has most recently been working from.
Your answer
Has s/he previously taken lessons for any other musical instrument (guitar, violin, flute, etc.)?
Do you have any long-term goals in taking piano lessons?
Your answer
How did you hear about Charlotte’s Piano Studio?
Your answer
Parent/Guardian Name
(if student is under age 18)
Your answer
Your answer
Contact Number
Your answer
Your answer
Preferred method of contact:
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