Student Information Form (minor) Minor Student Information Form (To be completed by parent/guardian) Full Name(required) Email Address(required) Student's Full Name(required) Student's Birthdate(required) Phone Number(required) Residential Address(required) Has your child previously taken any private music lessons?(required) Yes No Has your child ever participated in choir, band, or orchestra?(required) Yes No Which lesson does your child wish to take?(required) Instrumental Lesson Voice Lesson Theory/Composition Lesson Other For instrumental lesson, which instrument would your child like to learn? Lesson Length(required) 30 minutes 1 hour Music Theory Students Only Individual Group of 2 Group of 3 Pay by month Pay by course Day Preference: Please indicate the days you are available for lessons. We cannot guarantee to offer the day of your request, but we'll try our best to accommodate it. (required) Monday Tuesday Wednesday Thursday Friday Saturday Sunday Time Preference: Please indicate the time slots you are available for lessons. We cannot guarantee to offer the time of your request, but we'll try our best to accommodate it. (required) 9 AM – 12 PM (EST) 12 PM – 3 PM (EST) 3 PM – 6 PM (EST) 6 PM – 9 PM (EST) Is there anything else you'd like to tell us? Submit Δ
Brookside Music Studio