New Students
Welcome to 89th Key Music Studio!  

New Student Registration Form
Student's Name:
Birthday:
Sex: 
Desired Start Date:
Please list any medical conditions or food allergies:
Piano Experience:
Student's Name:
Birthday:
Sex: 
Desired Start Date:
Please list any medical conditions or food allergies:
Piano Experience:
Student's Name:
Birthday:
Sex: 
Desired Start Date:
Please list any medical conditions or food allergies:
Piano Experience:
Parent Information:
Last Name:
First Name:
Address:
City:
State:
Zip Code:
Home Phone:
Mobile Phone:
Work Phone:
Other Phone:
Email Address:
Emergency Contact (Other than parent):
Name:
Phone Number:
Preferred Lesson Day:
1st Choice:
2nd Choice:
3rd Choice:
***Please note: lessons do not start earlier than 2:30pm on Mon, Tues & Thursday unless special arrangement are made in advance with Janie
Preferred Lesson Length:
Preferred Instrument or Lesson:
We are so glad you're here!  How did you here about our studio?:
Male
Female
Male
Female
Male
Female
Click here for text
20 minutes
40 minutes
60 minutes
Piano
Guitar
Voice
Ukulele
Drums
Song Writing
Theory