Parent's First and Last Name * First Name Last Name Parent E-mail * Parent Phone * (###) ### #### Preferred Contact Method E-Mail Phone Call Text Message Student's First and Last Name * First Name Last Name Student's Date of Birth * MM DD YYYY What instrument are you interested in studying? * Brass: Alto Horn Brass: Baritone Brass: Euphonium Brass: French Horn Brass: Trombone Brass: Trumpet Brass: Tuba Cello Flute Guitar: Acoustic Guitar: Electric Percussion: Drum Set Percussion: Orchestral Piano Ukulele Viola Violin Voice: Classical/Opera Voice: Jazz Voice: Musical Theater Voice: Contemporary/Pop Please tell us about your prior music experience and list any teachers you've studied with. * Do you have an instrument at home for practice? If yes, what kind? * What are your goals for private lessons? * Is there a specific teacher you are interested in studying with? How did you hear about us? * Friend/Family Referral Facebook Instagram Yelp X Youtube Irvine Moms News/Publication Flyer/Poster/Postcard E-Mail Instructor/Staff Referral Other If you were referred by another student or an instructor, please tell us who. Thank you!Thank you for your inquiry. A member of our team will be in contact with you shortly.Back to Programs Interview Lesson Request Form
