YMCA Music Lesson Interest Form

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Please complete this form if you or your child is interested in enrolling with the YMCA Music Program. We accept new students as availability allows.

**COMPLETING THIS FORM AUTOMATICALLY ADDS YOU TO THE WAITLIST. If an instructor has an opening for the instrument, time/day, and location that is indicated in your answers here, you will be contacted as soon as possible. Please note that if you are NOT contacted, a spot is not available just yet.**

Email *

Name of student *

Age of student: *

Past music lesson experience: *

No experience

A few lessons

1-2 years

2+ years

Instrument of interest: *

Piano

Guitar

Ukulele

Voice

Other

Practice in between lessons is essential to the progress of each student. Does the student have access at home to the instrument indicated above? *

Yes

I would like recommendations of where I can purchase/rent an instrument

Location preference: *

Dahl YMCA (La Crosse)

Houser YMCA (Onalaska)

No preference

Please indicate the days/times the student is available for lessons:

Please select all that apply

Morning

Afternoon

Evening

Mondays

Tuesdays

Wednesdays

Thursdays

Fridays

Saturdays

Sundays

Please list a parent/guardian name AND phone number. *Please note that this info will be used to contact you with an available lesson time. *

A copy of your responses will be emailed to the address you provided.

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