GUITAR STUDENT REGISTRATION FORM

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A+ Music Studios

P.O. Box 241204, Apple Valley, MN 55124

Call 952-322-2520 or 612-710-0800 to Register by Phone

DATE:__________________________

STUDENT NAME:_______________________________________________________

ADDRESS:_______________________________________________________________________________________________________________

CITY/STATE/ZIP:__________________________________________________________________________________________________________

EMAIL:___________________________________________________________________________________________________________________

We require an e-mail address as we communicate via e-mail to our students and their families regarding tuition payment reminders, holiday closings, etc.

HOME PHONE:__________________________________________

ALTERNATE PHONE: ____________________________________ TYPE: Cell ____ Work ____

ALTERNATE PHONE: ____________________________________ TYPE: Cell ____ Work ____

STUDENT D.O.B: ______________________________

PARENT(s) NAME: (If student is a minor)____________________________________________________________

NAME OF A+ MUSIC STUDIOS INSTRUCTOR CHOSEN: __________________________________

LIST THE TIME SLOT THE INSTRUCTOR HAS RESERVED FOR YOU:  DAY: _____________TIME:_________

LESSON LENGTH:  30 min. _____     45 min. _____      60 min.______

GUITAR(s) CURRENTLY OWNED:   Steel String______    Electric ______   Acoustic/Electric______  Bass _______  Classical (nylon-string)_______              None_______

DO YOU READ MUSIC: Yes _____ No _____          GUITAR TABLATURE:  Yes _____ No _____

Circle the playing STYLE(s) you would like to learn:   Pick      Fingerstyle     Strumming chords

HOW LONG DO YOU PLAN TO STUDY: ______ months ______ years

a) Specific songs you would like to learn (title and composer/artist/group)

b) Artists or groups whose music you would like to learn

1.:_______________________________________________________________________________________________________________

2.:_______________________________________________________________________________________________________________

3.:_______________________________________________________________________________________________________________

4.:_______________________________________________________________________________________________________________

5.:_______________________________________________________________________________________________________________

6.:_______________________________________________________________________________________________________________

WHERE DID YOU HEAR ABOUT US?

Brochure at: _____________________________________________________________   

Poster/Business card at: __________________________________________________

Printed advertisement in__________________________________________________

Yellow Pages:  Frontier____    Qwest Dex____    Verizon____     Yellow Book_____

Internet Search: _____Referred by__________________________________________