Dahl Private Studio Waitlist

1

Contact Name* This field is required.

First Name

Last Name

2

Mobile Number* This field is required.

Area Code

Phone Number

3

Can you send and receive texts on this number? * This field is required.

YESNO

4

Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

5

E-mail* This field is required.

6

How did you hear about Dahl Studio?

7

Student Name* This field is required.

First Name

Last Name

8

Student Birth Date* This field is required.

9

Prior Experience* This field is required.What prior experience has the student had with music instruction, including piano instruction as well as other instrument/vocal instruction?

10

What instrument/instruments are you interested in studying?

11

Preferred Lesson Days and Times* This field is required.Please indicate your preferred lesson days and times.

Tuesdays

Between 8am and 2pm

Wednesdays

After 3pm

Thursdays

I would need a different day/time

12

Studio and Piano Goals* This field is required.Please tell me a little about why you would like to join our studio specifically, or why you would like your student to pursue piano in general. What are your goals for your student? What are your student's goals?

13

Getting to Know You* This field is required.Tell me a little about your family dynamics. Do you have a background in music? What level of help will your student have at home? Are there any medical issues, food sensitivities, or special needs I should be aware of regarding your student? Is there anything else you would like to share?

14

Studio Policies* This field is required.Please read the following studio policies and check each, indicating you have read and agree to abide by them.

Tuition is auto-withdrawn monthly.

Tuition is due regardless of how many lessons are attended. For private piano, I do try to accommodate rescheduling lessons if given enough notice. Short notice due to illness can be accommodated. Please do not come to lessons if sick!

Summer Camp is required to retain your lesson spot.

15

Media* This field is required.I give permission for Dahl Studio to use my child's likeness on the Dahl Studio fb page and in other social media and advertisements.

Yes

16

Equipment at home* This field is required.I understand that private lessons require daily access to an instrument at home. For piano, this means either a regularly tuned full-sized acoustic piano or a full-sized digital piano with weighted keys and pedal.

Yes

17

Additional CommentsPlease leave any additional questions or comments here or contact us at Dahlstudiolv@gmail.com or by phone at 702-283-6163

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