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2358 Washington Road, Augusta, GA
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Piano Lessons Form
Amber Rickerson
2022-05-11T17:49:49+00:00
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Name
*
First
Last
Email
*
Cell Phone Number (Numbers only)
*
Address
*
Who Are Lessons For?
*
Self
Child
Grandchild
If child or grandchild(ren) please list name(s) and age(s).
Is our location convenient for lessons?
Yes
No
Would you rather have someone closer to your home?
Yes
No
Current Skill Level of Student
Beginner
Intermediate
Advanced
What Day(s) Work Best For Your Schedule?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What Timeframe(s) Work Best For Your Schedule?
Morning
Afternoon
Evening
Please list any days / times that should be excluded or when you cannot take lessons.
Any Preference for Instructor?
Male
Female
Doesn’t Matter
Any Preference For Instructor's Personality?
Would you or your child/grandchild do better with a more outgoing teacher, soft spoken, or no preference?
What is your goal with piano lessons, and/or what do you want to accomplish?
Examples: to play hymns at church, personal enjoyment, to play jazz, classical music, or learn to play by ear, etc.
Is there an instrument in the home to practice on?
*
Yes
No
I would like to purchase an instrument.
Please send me information about renting an instrument.
If you have a piano, what is name or brand?
If you own a piano what is the approximate age of your piano?
When was the last time the piano was tuned?
Is it a full 88 keys and touch sensitive/weighted keys?
Yes
No
We feel for lessons to be of benefit, a proper instrument is required in the home in order to practice. Do you understand and agree to this?
*
We have a wonderful rent to own program on both pianos and keyboards. Would you like to know more about that?
Yes
No
Did you know that we tune pianos? Would you like to know more information on this service?
Yes
No
Would you be interested in our piano moving services?
Yes
No
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