Your Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

I am interested in *

Group Class: Intro to Guitar

Group Class: Intro to Ukulele

Group Class: Intro to Band

Piano Masterclass

Piano

Guitar

Drums

Voice

Bass

Ukulele

Banjo

Studio Location *

Fullerton

Costa Mesa

Huntington Beach

Whittier

Preferred days to meet: *

Monday

Tuesday

Wednesday

Thursday

Friday

When would you be available for a weekly lesson? *

Select all the times that work for you.

Early morning (8am-10am)

Late morning (10am-12pm)

Early afternoons (1pm-3pm)

Mid-afternoons (3pm-5pm)

Evenings (5pm-7pm)

Is the student able to read music? *

Yes

No

Chords? *

Yes

No

Musical Background

Does the student have any formal instruction/musical experience?

No previous musical instruction/experience

0-2 yrs informal/self-taught experience

2+ yrs informal/self-taught experience

0 - 2 yrs of formal instruction

2 - 4 yrs of formal instruction

4+ yrs of formal instruction

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