- Anderson Music Studio

Student Type *

Child
Adult

What Instrument? *

Student Name *

First

Last

Parent/Guardian 1

First

Last

Relationship to Student *

Parent/Guardian 2

First

Last

Relationship to Student

Student's Birthday *

MM/DD/YY

Email *

Primary Phone Number *

Preferred Mode of Communication *

Phone
Text
Email

What day are you available for lessons? *

Monday
Thursday
Friday
Saturday

Please indicate any days/times you are strictly unavailable for lessons: *

How long would you like the lesson to be? *

Anything you'd like me to know?

Just like school teachers, the more I know about your child the better. Any learning disabilities, severe allergies, home situations, etc. are helpful to know.

If you have a referral or discount code, leave it here:

Policy Confirmation *

I have read and understand Anderson Music Studio’s policies.

e-Signature *

By typing your name in this box, you are agreeing to abide by the policies of Anderson Music Studio. You also agree to have your phone number and email address shared privately with members of Anderson Music Studio for contact and rescheduling purposes. We will always respect your privacy, and will not share your contact information with anyone outside of our organization without your consent.