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Name:
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Age: |
(if under 18 years of age) |
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Parent or Guardian |
(if under 18 years of age): |
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E-mail Address:
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Mailing Address:
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City, State, Zip:
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Home Phone Number:
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Work Phone Number:
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Cell Phone Number:
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Instrument (s):
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Years of Study:
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Last Teacher:
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How long were your lessons
(30 minutes, 45 minutes, 1 hour) and how frequent:
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Method of Study:
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Style of Music:
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Level:
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Studied Music Theory:
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Yes
No
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Scales:
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Yes
No |
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Chords:
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Yes
No |
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Arpeggios:
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Yes
No |
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Studied Technique:
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Yes
No
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Books Used:
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1.
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2.
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3.
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Knowledge of Music Technology:
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Studied Music Composition:
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Yes
No
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Current Repertoire and
Composer
(List at least 1-5 songs):
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1.
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Do you like to
perform in front of an audience:
Yes
No |
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If yes, past
performances and/or auditions: |
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If no, why: |
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Awards or
recognition: |
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Short-Term
Musical Goals: |
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Long-Term
Musical Goals: |
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PS School regular hours of
operation are:
Monday - Thursday 2:00 pm - 8:30 PM
Friday 2:00 PM - 7:30 PM
Saturday 9:00 am - 2:00 PM
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Please list times and days
(in order of preference)
available for you to take classes/lessons:
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1.
3.
5.
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2.
4.
6.
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PS School is closed:
January - New Year's Day
May - Memorial Day
July - Independence Day
September - Labor Day
November - Thanksgiving
Day
December -
Christmas Eve, Christmas Day, New Year's Eve
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| Are you able to commit to year-round instruction:
Yes
No |
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If not, please explain why: |
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Are you interested in
participating in our other activities (master classes,
workshops, singing and instrumental groups, jam sessions,
recitals):
Yes No |
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How did you
hear about the Peggy Still School of Music: |
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| Thank you for applying. |
| We will call you to set up an appointment time for
the interview/audition. |
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Privacy
Statement:
The information which you give in completing this form will be
forwarded to the designated party for its use and will not be used
for any other purpose or provided by The Peggy Still School of
Music to any other parties. If you wish information concerning the
privacy policy or the designated recipient, you should contact
them directly.
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Please
contact us about piano sales and rentals and band/orchestral
instrument sales.
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We
accept: American Express, VISA, & Mastercard.
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