Registration Form - Studio Spicer
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Download/print the Registration Form & Policy in PDF
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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.
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REGISTRATION
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The
process of beginning music instruction with me usually follows this
process:
1) Initial Contact - the prospective student contacts me:
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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:__________________________________________________________ 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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