New Student Availability Form

Student Name*

Parent(s) Name (if applicable)

Email Address* (Parents', if applicable)

Student Age*

Phone Number* (Parents', if applicable)

Address*

How long of a session?*
30 Minute45 Minute60 MinuteUnsure

What instrument is the student interested in studying?*

For how long has the student studied their instrument?*

Describe student's ability to read music.*

What teaching style are you looking for?*

Is the student interested in studying a specific genre/style of music?*

What type of lessons are you interested in?*
In-person lessonsOnline lessonsNo preference

What days are you available?*
MondayTuesdayWednesdayThursdayFriday

Please specify what times work best for you on the days you selected above.*
Before 1:00 pm1:00-3:00 pm3:00-5:00 pm5:00-9:00 pm

How did you hear about PCM?*
Web SearchNewspaper/Magazine AdSocial MediaReferred by friend or familyOther

If you selected "other" above, let us know how you found us.

Any other comments or questions?

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