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.
process of beginning music instruction with me usually follows this
1) Initial Contact - the prospective student contacts me:
Studio Spicer –
Piano/Music Lessons Registration Form & Policy
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:__________________________________________________________
Given Name(s): _____________________________________________________
Date of Birth: _____________________________________ Sex: ______(f/m)
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)? __________
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 _____
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