First Name
Last Name
Phone
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Email
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Alternate/Emergency Contact
Alternate/Emergency Phone
Do you have an instrument at home for practice?
Yes
No
Are there musicians in the home who can help outside of lessons?
Yes
No
Student #1
Student #1 Birthday
Student #1 Lesson Choice
Student #2
Student #2 Birthday
Student #2 Lesson Choice
Student #3
Student #3 Birthday
Student #3 Lesson Choice
Student #4
Student #4 Birthday
Student #4 Lesson Choice
Is there anything we need to know about the student (s)?
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Social Media
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Friends/Family
Other
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