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Waiting List Request
Kimberly's Piano Room
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Email
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Your email
Do you agree to my Studio Policies?
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Please read to ensure you're happy with lesson fees etc.
2024 Studio Policies
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No, I do not agree
Child's Full Name
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Your answer
Child's Date of Birth
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DD
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YYYY
Parents'/Caregivers' Names
*
Your answer
Phone Number/s
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Your answer
Child's previous/current musical education
*
Your answer
Parents'/Caregivers' musical background
*
Your answer
Why would you like to put your child into piano lessons?
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Your answer
What kind of piano/keyboard do you have in your home?
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Your answer
How much practice would you expect your child to be able to do during the week?
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Your answer
What school does your child attend?
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Your answer
What is the earliest time you could be at a lesson after school?
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Your answer
What is the latest time your child could finish their lesson?
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Your answer
Are there any days/times you could not attend a lesson?
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Your answer
What are your ideal lesson times/days?
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Any other comments?
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A copy of your responses will be emailed to the address you provided.
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