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Student Enrollment Form
Parent/Guardian First Name
*
Parent/Guardian Last Name
*
Parent/Guardian Email
*
Parent/Guardian Phone Number
*
Student Name
*
Student Birthday
*
Month
Day
Year
Instrument student would like lessons for:
*
Piano
Guitar
Both
Student Skill Level
*
None - never had lessons before
Beginner
Intermediate
Late Intermediate
Advanced
If taken lessons previously, please elaborate on experience (# years of lessons, books used, level of books, etc)
*
Is there anything you'd like us to know about your student - such as allergies, learning differences, or anything else - that would help us best support their learning and experience?
Would you like to add another student?
*
Yes
No
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