Student Piano Lesson Interest Form

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Private Lessons
Performances
Testimonials
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Fill out the form to start piano lessons.

Parent/Guardian Name (required)

Parent/Guardian Email (required)*

Parent/Guardian Phone (required)*

Student Name

Address Line 1 (required)*

City (required)*

State (required)*

ZIP Code (required)*

Preferred Lesson Length (required)*

30 min/wk

45 min/wk

60 min/wk

Please enter any days or times that will NOT work for lessons due to scheduling conflicts, OR enter a specific time that WILL work if we have already discussed it. (required) Note: Available lesson times are Tuesday -Thursday, 9AM - 8PM.

Preferred Start Date (required)

If you have taken lessons previously, what level would you describe yourself?

Beginner (taken lessons 1-3 years)

Intermediate (taken lessons 4-6 years)

Advanced (taken lessons 7+ years)

Is your child starting lessons for the first time with our studio?

Yes, my child is beginning music lessons for the first time.

No, my child has taken lessons previously from another teacher or studio.

Do you have a piano/keyboard, at home?

Yes

Not yet, but I'm working to get one before lessons start.

My child is excited about music lessons because...

Does your child have learning needs to be aware of? If yes, this info helps the teacher to prepare and teach your student in the best possible way.

Contact

Reach out to start your musical journey

Email

Phone

Stromschoolofmusic@gmail.com

(941)-780-7921

Your full name