Registration Form for Guitar or Piano Lessons

PLEASE NOTE: Some of the questions below will only apply to adult students.
Name:
If registering a child please indicate D.O.B.:
Address:
City:
Phone Number:
Cell Phone Number:
Email Address:
Interested in taking lessons in:	Guitar Piano
Current Music Skill Level:	Beginner Intermediate Some experience
If you are more than a beginner, how many years have you been playing and what method were you taught?:
What are you most interested in learning?:	Ear training Rhythm Notation Technique Improvisation Sight reading Specific songs
Why do you want lessons?:	To play with family and friends It is on my "bucket list" I'm thinking of making it a career Another Reason
How did you hear about us?:	Yellow pages Hamilton Culture & Recreation Guide Friend Google Search Other
If other:
Special Needs/Concerns/Comments: