Private Lesson Registration Form
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Student Name *
Student Birthday *
MM
/
DD
/
YYYY
Instrument *
Required
Please select your desired lesson length: *
Which lesson model are you registering for? *
SUBSCRIPTION LESSONS:
Please select your preferred teacher!
SUBSCRIPTION MODEL: What day of the week are you available for lessons (Please select all that apply). The studio is closed Fridays and Sundays.
SUBSCRIPTION MODEL: Please list you preferred day & time for fall and your second choice time.  *
PACKAGE MODEL: Please select how many lessons and the duration you’d like to purchase: (NO NEED TO SELECT IF YOU ARE SUBSCIPTON)
Clear selection
Best way for us to follow up? *
How did you hear about us? *
NEW STUDENTS ONLY: Parent name (if under 18):
GUARDIAN E-mail
NEW STUDENTS ONLY: Parent Phone Number
NEW STUDENTS ONLY: Address
NEW STUDENTS ONLY: Student e-mail (if available)
NEW STUDENTS ONLY: Student phone number (if available)
NEW STUDENTS ONLY: Have you taken lessons before?
Clear selection
NEW STUDENTS ONLY: If yes, tell us about it!
NEW STUDENTS ONLY: Where did you hear about us?
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