JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Musical Interest Survey
Please fill this out to help us create the most convenient classes catered to you. Classes are open to the public and lessons will likely be held at Ms. Miller's Home Music Studio/Peaceful Backyard. Cross Streets are University Ave and 54th Street. If you need an online option for health or travel circumstances, we can stream our classes so you can participate.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
What are the student's names who want to take music classes? Parents/Guardians welcome to join in our classes as well.
*
Your answer
How old are the students who are interested in music classes?
*
Your answer
Do they have prior music experience? Please explain. Beginners Welcome
*
Your answer
What are the names of the student's parents/guardians?
*
Your answer
What is the best phone number and email to reach you at?
*
Your answer
Where do they attend school? If at home, please include the home school charter they belong to if applicable.
*
Your answer
Do you already know what instrument the students want to play and/or would you like to attend a free instrument sampling session? Instrument sampling session is recommended for all students, especially those joining band/orchestra. Ms. Miller is great at helping kids find the right fit for them!
*
Yes I'd like to attend a free instrument sampling session.
We already know what instrument/type of class my students want
Other:
What type of class are you interested in? Most classes can combine for Show Time performance! Show Time students will take classes in the primary instrument groups until they are ready to combine to rehearse together. Similar ages will be grouped together for primary lessons. Parents/Guardians welcome to join in our classes as well. Select as many as you wish.
*
Beginning Band (Flute, Oboe, Clarinet, Bassoon, Saxophone, French Horn, Trumpet, Trombone, Baritone, Tuba, Percussion and Bass Guitar)
Beginning String Orchestra (Violin, Viola, Cello, Double Bass)
Jazz/Pop Ensemble (For students who have played their instrument for many years and are very proficient at advanced music reading)
Color Guard (Spinning Flags and Other Equipment with Costumes and Dance Choreography)
Music Mix: Piano, Singing, Rhythm and Music Games (Kids ages 4-8)
Ukulele/Guitar/Piano Class (Available for kids 8 and Up)
Percussion/Drum Class
Choir/Singing/Song Writing
Other:
Required
What music option would work better for your summer schedule?
*
A condensed week or two between July 11-July 29 where students come to learn for a few hours each day.
Once a week group lesson starting the week of July 4th
Other:
Required
If you selected a weekly group lesson for summer please tell us your preferred days of the week and time frame
*
Your answer
When the school year starts, what approximate days and times would work best in your schedule for music classes? Are you available for classes during typical school day hours 9am-3pm?
*
Your answer
Do your children have any specialized learning needs? Is there anything you'd like Ms. Miller to know to best help them learn?
*
Your answer
Do you know any other families we should reach out to who may be interested in classes? The more students we have, the more the price per class decreases for families. Please list their contact info here:
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
