Name *

First Name

Last Name

Phone *

(###)

###

####

Who will be taking the lessons? *

I will be taking lessons

My child will be taking lessons

I want to gift these lessons to someone else

Day(s) That Work Best For You *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Preferred Time of Day *

We can further discuss scheduling options!

Hour

Minute

Second

AM PM

Genre Interests *

Check all that apply

Rock (classic/hard/alternative)

Jazz

Funk

Metal

Musical Theater

Pop

R&B

Singer-Songwriter

Other

Specified Goals *

Check all that apply

Casual/Learning for fun

I want to be a performing artist

I want to go to music school

I want to learn how to write songs

I can already sing and want to accompany myself

Other