Private Piano Lessons Sign Up FormHello! Once I receive your form I will email you with current available time slots. Student Name * First Name Last Name Email * Parent or student email. This is where communication and important documents will be sent, so please put the best email for contact. Student Phone If student has a phone and will be responsible for communication via text, please add. If you do not want your student to have text contact please leave blank. (###) ### #### Student's Age *If applicable. N/A for adult piano students. Student's Grade *If applicable. N/A for adult piano students. Does the student have any prior music knowledge/experience? * If yes, please provide a brief description below. What level of piano is the student? * If student is a beginner, please put "none". If unsure of level, please provide how long you have been playing. Parent/Guardian Name *If applicable. N/A for adult piano students. First Name Last Name Parent/ Guardian Phone Number *If applicable. N/A for adult piano students. (###) ### #### Can I text this number? Yes No Emergency Contact * First Name Last Name Emergency Contact Phone * (###) ### #### Relationship to student? How is the emergency contact related to the student? Does the student have any allergies? If yes, please list below. Which teacher are you interested in lessons with? * *Please note: Aubree accepts CASH payments only (Cash, check, Venmo, Cash App and Zelle.) Dena Reeves Aubree Shibley No preference, whoever has availability Payment Plan * *Please note: CASH payments are received in cash, check, Venmo, Cash App, and Zelle. Pay full amount in CASH at the beginning of the semester. Pay monthly (at the beginning of the month) in CASH. Pay monthly (at the beginning of the month) in CHARTER FUNDS. Thank you! You will receive an email from me shortly to complete the sign up process for your student!