Registration

Would you like to register for classes? Fill out this form and feel free to contact me with any questions.

Student Name*
First Last
Parent Name*
First Last
Email*
Cell Phone*
Alternate Phone
Length of Lesson*
Location of Lesson*
Preferred Lesson Times
Weekday (3:30pm - 10pm)
Preferred Starting Time

: Hours

Minutes
Genres Preferred
- Classical
- Popular
- Jazz
- Rock
- Broadway
- Holiday
Describe any Previous Experience
Hobbies and Interests