Registration for Essential Music Lessons
Fill out this form to start the registration process for yourself, or your child, to study with Essential Music Lessons. Once this form is filled out, we will email you a contract with the tuition and monthly payment, and all policies. When you receive that form, sign it and return it to Essential Music Lessons to complete registration. Your lesson/class spot is not confirmed until registration is complete. 

If registering more than one student from the same family, you can put answers for both on the same form if desired.

If you have any questions or concerns about this form, please email EssentialMusicLessons@gmail.com. 
Sign in to Google to save your progress. Learn more
Email *
Student Name (Last, First)  *
Preferred Pronouns
Age of student, if under 18 (if 18 or over, write N/A) *
Student Phone (if none, write none) *
Student Email (if none, write none) *
Parent(s) Name(s) - Last, First - if not applicable, write 'none' *
Parent(s) Email(s) - If not applicable, write 'none' *
Parent(s) Phone Number(s) - if not applicable, write 'none' *
If any others may be bringing the student to or picking the student up from lessons, please give their names and phone numbers here. These persons will also be considered Emergency Contacts in the event that parents cannot be reached. 
Other Emergency Contact - Name and Phone #  *
Student Mailing Address *
Please share any medical concerns, food allergies, or learning differences the student has that we need to be aware of. If none, write 'none.' *
Describe student's prior musical experience. *
Describe the instrument the student has at home to practice on. Give as much detail as possible. (e.g. keyboard, digital piano, upright, baby grand, brand, model, number of keys, weighted or not, age.) If not applicable, write 'none.' *
If you have an acoustic piano, do you have a piano tuner?
Clear selection
What instrument does the student play, or what voice part does the student sing? If none, write "none.' *
Has the student previously taken private lessons? *
If yes, how long did the student study privately?
If yes, what is the name of the most recent instructor, and how long did the student study with this instructor?
Has the student previously studied music theory? *
If yes, please describe the course.
How did you hear about Essential Music Lessons? *
What made you choose to take lessons or classes through Essential Music Lessons? *
What other options did you consider before choosing Essential Music Lessons? *
Why have you/has the student chosen to study music? *
What goals do you/does the student have for the next year? (These do not need to be only music-related.)  *
What has been your favorite part of studying with Essential Music Lessons? (If just starting, write N/A) *
What is one way Essential Music Lessons can improve? (e.g. services, website, scheduling, etc.)  *
What program is the student registering for? *
We will do our best to schedule lessons and classes at times that work for everyone. What days and times would you consider? All times are in Eastern Time Zone. Please check all suitable answers.  *
Required
If you have previously studied with Essential Music Lessons, do you wish to keep the same day/time, or are you willing to change to another day/time?
Clear selection
If you must keep the same day/time, what is the day and time you had lessons scheduled?
Do you wish to take lessons in-person or online? *
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