Enrollment form

Name:

First

Last

Date of Birth:

Gender:

Parent / Guardian's Name (if student is under 18):

Email:

Phone number:

Address (optional, for correspondence):

Lesson Preference:

Current Piano Skills:

ABRSM or Trinity Exam Details (if applicable):

Select the grade for which you are appearing in the exam.

Have you previously taken any ABRSM exams?

Have you previously taken any Trinity exams?

Do you have prior experience playing the piano?

Do answer that

If yes, how many years?

Preferred Lesson Format:

Preferred Lesson Duration:

Preferred Days for Lessons (select all that apply):

Why do you want to learn the piano? (short answer field)

Do you have a specific piece or goal you’d like to achieve?

Do you own a piano or keyboard for practice?

Emergency Contact Information (optional):

I confirm that the information provided is accurate.

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