School-age Student Information Form
This form is for school aged children (age 6-18). Please answer section 1 from the student's perspective. Section 2 will cover family information.
Sign in to Google to save your progress. Learn more
Student Name *
Age *
Date of Birth *
MM
/
DD
/
YYYY
Student Phone Number (if available)
Student Email address (if available)
School *
Grade (in 2017-18) *
Does your student have digital access (iPad, laptop, etc.)? *
Do you have a musical background? *
Which best describes you? *
Why do you want to take piano lessons? *
Do you have regular access to a piano or keyboard? *
How long do you think you will be able to practice each week? *
Do you have any allergies or medical conditions that I should know about in case of emergency? (Response to this question is voluntary. Please only include important information I may need to know about - all information will be kept confidential)
Do you have any questions or anything to add?
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy