Long FormInterest Form Student #1 Name* First Last Student #1 AgeStudent #2 Name First Last Student #2 AgeAre you interested in Online Lessons?* Yes NoAre you interested in In-Home Lessons* Yes NoArea of Study Student #1 Music Lessons Academic SubjectsSelect Music Lessons Instrument for Student #1PianoVoiceViolinViolaCelloString BassGuitarUkeBanjoMandolinElectric BassFluteClarinetSaxophoneTrumpetTromboneFrench HornBaritoneTubaPercussionDrum SetSelect Academic Subject(s) for Student #1MathEnglish Language ArtsSpanishWritingScienceSocial StudiesHistoryACT/SAT/IB/GRE Test PrepHow Many Years of Study Student #1Books or Materials Student #1Do you have books or materials? Will you need instructor to bring a book or materials to the first lesson.Area of Study Student #2 Music Lessons Academic SubjectsSelect Music Lessons Instrument for Student #2PianoVoiceViolinViolaCelloString BassGuitarUkeBanjoMandolinElectric BassFluteClarinetSaxophoneTrumpetTromboneFrench HornBaritoneTubaPercussionDrum SetSelect Academic Subject(s) for Student #2MathEnglish Language ArtsSpanishWritingScienceSocial StudiesHistoryACT/SAT/IB/GRE Test PrepHow Many Years of Study Student #2Books or Materials Student #2Do you have books or materials? Will you need instructor to bring a book or materials to the first lesson.When would you like to start?*Please enter desired start date.Availability*Provide all days of the week and time frames that you would be available for a lesson. Required to locate an instructor in your area.First Parent Name* First Last Second Parent Name First Last Home Address*Required to locate an instructor in your area. Lessons are in your home. Academics and Spanish lessons may be scheduled in a library. Lessons are also scheduled in after school programs at pre-approved schools with room availability.Mobile Phone*Best Time to ContactContact Phone NumbersList all contact phone numbers, cell phones and landlines.Email* CAPTCHA
