Lesson Inquiry Form

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Lesson Inquiry Form

Thanks for contacting us! Please fill out this form and we will contact you with more information, set up a Free 15min Trial Session if you'd like, and/or help you with registration.

If you have any questions, please email us at hello@bergenacademy.com. Thank you!

How did you hear about us?

Passed by

Word of mouth

Internet Search

Other:

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Student's Full Name (First, Last) *

Student's Birthday (Month/Day/Year) *

Which instrument(s) are you interested in? (Choose all that apply) *

Piano

Voice (Singing)

Guitar

Ukulele

Violin

Viola

Bass

Other:

Required

Are you a beginner student? If you have prior experience, how much experience? *

Parent/Guardian Full Name, or "Self" (Title/First/Last) *

Phone Number (Please indicate whether cell/home number) *

Email Address *

We offer a Free 15-minute Trial Session. We generally try to schedule it for a day/time that would become your official lesson spot should you choose to enroll. Would you like to register for a free trial? *

Yes (Please answer the next questions regarding scheduling availability)

Not sure yet, I'd like more information first

Other:

Do you have any questions or comments? Is there anything you'd like to share about yourself that would help us find the right teacher for you?

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