INTERCESSION PRIVATE LESSON APPLICATION

Thank you for your interest in Private Lessons during this intercession. Please consult our website for available class times before filling out the entire application. Only completed applications will be considered for admission into our program. We look forward to working with you soon.

STUDENT INFORMATION

Student First Name

Student Last Name

Household Primary Email

Household Email

Household Preferred Phone

Household Phone Number

Current Grade

School

Other School

DEMOGRAPHIC INFORMATION

Race

Gender

Date of Birth

LESSON INFORMATION

How long have you played the violin/viola?

Do you rent or own your violin/viola?

RentOwn

Does your school have an orchestra program?

YesNo

Are you a participant in the orchestra?

YesNo

Please briefly describe your music experience

Please tell us why you want to take violin/viola lessons

Do you have school or extracurricular activities that may pose a potential conflict with enrolling? If so, explain your scheduling conflicts:

PARENT/GUARDIAN INFORMATION

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Preferred Email

Email address

Parent/Guardian Preferred Phone

Parent/Guardian Phone Number

Household Mailing Street

Household Mailing City

Household Mailing State

Household Mailing ZIP/Postal Code

ADDITIONAL INFORMATION

Additional questions, comments, or concerns:

INTERCESSION PRIVATE LESSON APPLICATION

Private lessons are one-on-one lessons offered virtually through ZOOM. A link to connect for your private lessons will be sent via email.