Student Application

Scottsdale Piano Academy Student Application

Your full name (required):

Student's full name (if different than above):

Age of student:

Email address (required):

Best phone number to contact:

Who referred you to the studio?

If referred by a teacher or current student, please enter their name:

Preferred lesson day(s):

Weekday time preference (First choice):

Weekday time preference (Second choice):

Weekend time preference:

Please comment on any prior PIANO experience of student:

Please comment on any prior MUSICAL experience of student (band, orchestra, choir etc):

This question is to be filled out by the adult, parent or child applying: Why do you, or your child, want to begin/continue piano lessons? Describe the goals and expectations you have yourself, or for your child's lesson experience. Also include any additional information that you think I should know. Please be specific.