Student Name:
Class Year: FY SO JR SR Other:
Your Email:
Campus Phone:
Musical Knowledge: None at all I have experience in choir(s) and/or voice lessons I read treble clef I read bass clef I play (an)other instrument(s) Please List instruments
Previous Piano Experience: None at all Some exploration, but no lessons I used to know a few songs.
In the space below, provide brief details regarding your previous musical experience, if any:
What music (style[s], artist[s], composer[s]) do you like to listen to?:
Why did you register for Piano Class? What do you hope to gain from the course?:
What worries/fears do you have about the course?:
Physical Dexterity: I am a proficient typist. I can drive a manual transmission (“stick-shift”) vehicle. I have disciplined (ballet, modern, tap, etc.) dance experience.
What other comments/questions would you like to share with the instructor before class begins?: