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Lesson Preferences

Please click on the BACK button to your right. Then click to sign up or request more information. We will contact you as soon as possible - thank you!


PRIVATE MUSIC LESSONS
Please complete this short questionnaire and we will
contact you as soon as possible. Thank you!

* required

*1) Student Name

(50 characters max)

*2) What is the student's age? (if not an adult)

(10 characters max)

3) Parent or Guardian (if student is under 18 yrs.)

(50 characters max)

*4) Email

(100 characters max)

*5) Phone Number/Cell Phone Number

(100 characters max)

6) Address

(100 characters max)

7) City

(100 characters max)

8) State

(100 characters max)

9) Zip

(100 characters max)

*10) What is the best way to contact you?
Phone
Email

11) What is your FIRST CHOICE for music lessons location?
Las Vegas North store
Las Vegas East (Green Valley) store
Las Vegas West (Sahara) store

*12) What is your first choice for lesson day and time?

(1000 characters max)

*13) What is your second choice for lesson day and time?

(1000 characters max)

*14) Which instrument(s) do you want to learn to play? Or voice?

(100 characters max)

*15) What is your level of music experience?
Beginner > 12345 < Advanced

*16) Do you own an instrument?
YESNO

*17) Do you want to rent an instrument?
YESNO

*18) Are you interested in our FAMILY PLAN discount?
YESNO

*19) How did you find out about our music education program?

(1000 characters max)

20) Other helpful information that will help us place you with the right instructor.

(1000 characters max)

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Your use of this site indicates your agreement to be bound by our Terms and Conditions. All prices and products subject to final price confirmation by the retailer. All contents © Copyright 1999- Retail Up! and FAMILY MUSIC ACADEMY. All rights reserved. This internet site is hosted by Retail Up!, a web site service provider to fine music stores nationwide.