Park Hill Piano Studio

* 1. Student First and Last Name,  Age

* 2. Parent(s) name and contact phone number

* 3. What is your street address?

* 4. At what email address would you like to be contacted?

* 5. What school do they attend? What grade?

* 6. Have they studied music previously? If so, where?

* 7. Does your student participate in extra-curricular activities? If so, what are they?

* 8. Does the student have access to an instrument for practicing?

* 9. Will the student be able to commit to a daily practice routine?

* 10. What is the desired outcome of music lessons for your student?