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student registration form
*
Indicates required field
Name (please register each student separately)
*
First
Last
If registering more than one sibling, fill out and submit a registration for each student.
Registration is for:
*
Fall, 2020
Spring, 2021
adult lesson pack
Choose One
*
Continuing student
Transfer Student
New Student
Best Phone Number (leave blank if continuing student)
*
What type of phone line is it?
*
Cell
Home
Work
Alternate Phone Number
*
What type of phone line is it?
*
Cell
Home
Work
Other
Email address
*
Parent name(s) if applicable
*
Address (leave blank if continuing student)
*
Line 1
Line 2
City
State
Zip Code
Country
Please select your lesson type and length
*
60 minute lessons in person $70
45 minute lessons in person $58
30 minute lessons in person $45
60 minute online lessons $60
45 minute online lessons $50
30 minute online lessons $40
10-lesson package (adult students) $600
5-lesson package (adult students) $325
Please list all times you are available for piano lessons Mondays & Wednesday for piano lessons live, or Tuesday & Thursday for lessons online
*
Please be complete in listing all times you believe you could make it so that I can arrange a calendar that works best for everyone. Group piano lessons are always at 4pm-5pm Fridays
How did you hear about Adam Revell?
*
Comments or questions
*
By registering for piano lessons on a weekly basis, I am paying for a weekly scheduled time, and am committing to being present and on time to scheduled lessons. I have read the
piano lesson policies
and understand them.
Please select one
*
I agree, and wish to register
I am contacting you about something else (please indicate in the "comments or questions'" field)
Register now
Home
Music and Piano Lessons
piano lessons policies
Pricing
Reviews
Registration form
Live
About Adam
Contact