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Student Information Form

Music

Below is a communication form you can use to contact me. Please fill out as much as possible and be sure to include a way for me to contact you (a phone number and/or an email address).



Parent Name Phone Number Email Address

Do you own a piano or keyboard? Yes (piano) Yes (keyboard) No



Prospective Student #1:

Name


Age


Amount of previous training:
0 (none)
Less than 1 year
1-2 years
3-4 years
5-8 years
More than 8 years
Prospective Student #2:

Name


Age


Amount of previous training:
0 (none)
Less than 1 year
1-2 years
3-4 years
5-8 years
More than 8 years
Prospective Student #3:

Name


Age


Amount of previous training:
0 (none)
Less than 1 year
1-2 years
3-4 years
5-8 years
More than 8 years



Please add any comments or questions you have below:


Music

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