*1.Student Name (First and Last)(Required.)

*2.Phone Number(Required.)

*3.Student Age(Required.)

*4.Does your student have previous experience with piano? If so, please briefly describe. (We specialize in young beginners so previous experience is not a requirement, but it helps us to know if they have had some time at the keyboard already)(Required.)

*5.During what time frame are you available on MONDAYS?

(Please provide the earliest time you can arrive at the studio -433 Monroe Street- followed by the latest you can stay. We will select a 55 minute class time within this time frame)

If you are not available on MONDAYS, type N/A(Required.)

*6.During what time frame are you available on TUESDAYS?

If you are not available on TUESDAYS, type N/A

(Please respond according to previous question’s directions)(Required.)

*7.During what time frame are you available on WEDNESDAYS?

If you are not available on WEDNESDAYS, type N/A

(Please respond according to previous question’s directions)(Required.)

*8.During what time frame are you available on THURSDAYS?
If you are not available on THURSDAYS, type N/A

(Please respond according to previous question’s directions)(Required.)

*9.During what time frame are you available on FRIDAYS
If you are not available on FRIDAYS, type N/A

(Please respond according to previous question’s directions)(Required.)

10.At Harmony Road Music School, you are an integral part of the learning process! We require our parents to stay for class and participate with their student through the first few semesters of learning. Are you or another grown-up available to attend class with your student?

Yes

No

Other (please specify)