Lesson Inquiry Please enable JavaScript in your browser to complete this form.Student's Name *FirstLastThis student is: *MaleFemaleOther / Prefer not to sayHow did you find out about Clavier-Werke? *Family, friend or neighborTeacher at schoolSignagePrinted AdOnline SearchYelpFacebookInstagramOtherLocation *Clavier-Werke West LakeClavier-Werke SouthPlease indicate where the student would like to attend lessonsInstrument and Classes *PianoVoiceGuitarViolinViolaCelloTheory LabPlease indicate which instrument(s) and class(es) the student prefersInstrument and Classes *PianoVoiceGuitarViolinViolaCelloTheory LabPlease indicate which instrument(s) and class(es) the student prefersDo you already have a piano? *I already have an acoustic pianoI already have a weighted keyboardI have access to a piano for daily practiceI will be purchasing a piano or weighted keyboard after enrollmentPlease mark one of the aboveDo you already have an instrument? *I already have an instrumentI have access to an instrument for daily practiceI will be purchasing/renting/borrowing an instrument before the very 1st lesson.Please mark one of the above. Students are required to bring an instrument to their trial lesson.Do you already have a guitar? *I already have a guitarI have access to a guitar for daily practiceI will be purchasing a guitar after enrollmentPlease mark one of the abovePrivate Lesson Length *30 minutes weekly30 minutes twice / week45 minutes weekly45 minutes twice / week60 minutes weekly90 minutes weeklyOtherPlease indicate the student’s preferred lesson lengthScheduling Preferences *Please indicate earliest lesson start and end times per day.Experience Level *Please provide past music experience. (“Beginner”, “2 years of piano”, etc.)Disabilities, Medical Conditions or Food Allergies *Does your child have any disabilities or medical conditions you would like to share with us in confidentiality? This type of information can often assist us when working with a student in their lesson.Age Range *Pre-schoolK – 12th gradeAdultPlease indicate where the student would like to attend lessonsStudent's Date of Birth *Please indicate the student’s birth month, date and yearStudent's Grade Level *Student's School *Please indicate which academic school the student attendsParent / Guardian Name *FirstLastEmail *PhoneAlternate Contact Name *FirstLastEmail *PhoneAddress *City *State *TexasAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip Code *Have you read & agreed to the Clavier-Werke Statement of Policy found here: clavierwerke.com/policies ? *YesHave you added us to your contacts or safe sender list to ensure our response email shows up in your inbox? *Westlake location: clavierwerke@gmail.comSouth location: clavierwerkesouth@sbcglobal.netSubmit
