Registration

Students name: _________________________________________

Parents name: ____________________________________
Address: _____________________________________________________________
Home Phone #: _____________________ Cell Phone #: _________________
Email Address: _____________________________________
Best way to be reached: email, home phone, cell
Best time of the day to be reached: morning, afternoon, evening

About the Student:

Age: ______________
Birthday: _______________________________
Grade Level & School Attending: ___________________________________________
Favorite class at school: ____________________________________
Hobbies/Sports/Other activities?:
_____________________________________________________________________________
_______________________________________________________________
Have you ever taken piano lessons before? For how long? _____________________________

Is there anything else you would like the teacher to know about your child?
_____________________________________________________________________________
_______________________________________________________________

I have read and understand the Piano Policies and agree to their terms
______________________________________________________________

Piano lesson day and time ______________________________