STUDENT NAME *

First Name

Last Name

PARENT/GUARDIAN NAME

Please include full name and contact details for Parent/Guardian of any students under age 18.

First Name

Last Name

Phone *

(###)

###

####

What do you want to learn?

Please select all that apply.

Classical

Bluegrass

Country

Jazz / Swing

Reading Music

Improvisation

Bowing Technique

Music Theory

Ear Training

Does your schedule permit 30 minutes of practice five days each week?

Yes

No

Lesson Preference:

Online Lessons

In-Person Lessons

Both

What is your preferred lesson length?

Note: 30 minute lessons are recommended for students under the age of 8.

30 Minutes

45 Minutes

60 Minutes

90 Minutes

Preferred Lesson Frequency:

Once per week

Every other week

Once per month

One-time Lesson