Registration Form - Studio Spicer

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Download/print the Registration Form & Policy in PDF

Please read the Policy section of the Registration Form before the interview.
You may fill out the Registration Form prior to coming to the interview or we can do this together.

 REGISTRATION The process of beginning music instruction with me usually follows this process:

1)  Initial Contact - the prospective student contacts me:
     email:    web:

2)  Our first discussion, either by phone or by email, is usually short; I usually answer a couple of questions, we decide if there is sufficient mutual interest, then we set a time for an interview.

3)  Interview - the student comes to my music studio. The student has the opportunity to ask me any questions related to how music lessons will go and request verification of
my credentials (my own music background, education, experience, certificates).  The interview is also where I might collect more information and make notes on the students' music goals; this helps me to tailor lessons individually.

4)  Registration Form - at the end of the interview, if the student/parent(s) is ready to make a commitment to music lessons, they can fill out the registration form.  Alternatively, if they need more time to think about the commitment to taking on music lessons, they can bring the form with them and contact me later with their decision.  The registration form collects biographical data (name, age, contact info, etc.). I also ask the student to communicate his/her music goals.  If you prefer, you can download/print the
registration form in advance and bring it to the interview with you.  I scan all completed registration forms and maintain these as PDF.  A digital copy is provided to the student ("client") or parent.


Studio Spicer Piano/Music Lessons Registration Form & Policy
Policy Date May 2013

This is NOT a contract and as such, the lesson day and time slot can be changed later as long as there is an open spot.

Interview Date: __________________________________________________________________

Prospective Student_____                  Continuing Student_____                   Transfer Student _____

Name of current teacher/music school:__________________________________________________________

SURNAME: _________________________________________________________

Given Name(s): _____________________________________________________

Date of Birth: _____________________________________    Sex: ______(f/m)

Email(s): _________________________________________________________________________________

Phone(s): _________________________________________________________________________________

Address (residence): ________________________________________________________________________

 The following should be decided between the student and teacher.

Preferred lesson day (Monday, Tuesday, etc.): ______________________________

Date of first lesson: _______________________ Time Slot: ________________________________

Lesson Duration & Fees: 

a)      30 minute lessons $900 annually, payable $90 monthly, payable at the 1st lesson of each month.

b)      45 minute lessons $1350 annually, payable $135 monthly, payable at the 1st lesson of each month.

c)      60 minute lessons $1800 annually, payable $180 monthly, payable at the 1st lesson of each month.

The base fee rate is $50.00 per hour ($25 for 30 min;  $37.50 for 45 min). Annual tuition is calculated by multiplying the hourly rate by 36 lessons.  Monthly tuition is calculated by dividing the annual tuition into 10 equal payments. The year is comprised of 36 lessons from September to June. See the calendar for the exact dates of all 36 lessons.

Please sign below to indicate that you have read and agree to my studio policy (on the following pages).

Signature of student/parent:____________________________________________________

Signature of teacher: _________________________________________________________


Previous Piano Instruction / Musical Background

Please indicate any previous music/piano lessons that you have had (grade/level achieved). Please indicate if you have had related musical experiences, such as singing in a church choir, school choir, played another instrument.

Current Skill Level:   Beginner    /    Intermediate    /    Advanced        (circle one)

Level of theory completed:  (rudiments, harmony, etc.): ___________________________________________

Music Goals             Formal (traditional classical) _____        Leisure (popular, by ear) _____   

(OPTIONAL):  Please briefly outline your interest and motivation for seeking piano/music lessons; what would you like to accomplish in piano lessons; what time-frame (how many months/years) do you think you might be willing to reach your goals in piano/music?




1.  Are you interested in participating in public performance opportunities such as piano recitals?__________

2.  Are you interested in competing in music festivals? (Calgary Kiwanis Music Festival). ?__________

3.  Are you interested in taking formal piano examinations (Royal Conservatory)? __________

 Other Info

Here you can indicate any other information that you think I should know about you in order to better fulfill your musical learning experience.



Referral Where / how did you find me/Studio Spicer?  (Please check one.)

Google _____      Other internet/web _____       ARMTA _____       APTA _____       Friend _____

Other: ________________________________________________________________________________________

ARMTA = Alberta Registered Music Teachers' Association          APTA = Alberta Piano Teachers' Association



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