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Contact information
Music Student Profile - Please fill one out for each child if multiple students are in the family.
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* Indicates required question
Student Name
*
Your answer
Parent / Guardian Contact Name
Your answer
Contact Phone #
*
Your answer
Is Texting ok to this # if an in depth discussion is not needed?
Yes
No
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Contact Email
*
Your answer
Student Home Address
*
Your answer
Private Music Lesson Instrument and # of Years Studied.
Your answer
Student Birthday
MM
/
DD
/
YYYY
Student Interest / Hobbies
Your answer
Is there anything else you would like me to know that would be helpful in having a great experience for all?
Your answer
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