Contact Information

Parent/Guardian or Adult Student Name*

Email*

Phone (optional)

Preferred contact method*
—Please choose an option—EmailPhoneEither

Student Details

Student Name*

Age*

Instrument(s) of interest*
PianoTrumpetTromboneFrench HornBaritoneTubaRhythm/Group

Experience level*
—Please choose an option—BeginnerSome experienceIntermediateAdvanced

Goals & Preferences

Special interests we can celebrate (optional)

Goals for lessons*

Preferred days/times*

Scheduling

Lesson type*
—Please choose an option—Private LessonsGroup Jam SessionsBoth

Funding Source*
—Please choose an option—SDRCSelf-DeterminationOut-of-Pocket

Consent

I consent to be contacted by Spectrum Sound Studio for scheduling music lessons.