Lesson Schedule Form

Student Information

Interested in:*

Name*

First Last

Age*

School*

Grade*

List previous music experience. (Current/continuing students can leave blank.)

List ALL available times to meet for a lesson. (Example: Tuesdays 3:00-7:00, Wednesdays 4:00-6:00)*

Is there any additional information we need to know about this student or their lesson preferences?

Parent/Guardian Name*

Name Relation

Phone Number*

Email*

Parent/Guardian Name

Name Relation

Phone Number

Email

How did you hear about DRUM Percussion Studio?*

Additional Contact Information or Notes

Phone

This field is for validation purposes and should be left unchanged.