Get your son or daughter into piano!
Hurry up Summer is upon us and room is limited!
Please fill out this application easily by copying and pasting into an email and send it to
leekassandra@hotmail.com
Piano By Kassandra
Private Piano Lessons
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Parents / Guardian
First Name _____________________________ Last Name________________________________Childs' Name ___________________________ BOY GIRL (please indicate)Age of Child _________Address _______________________________________ Phone Number _____________________Email __________________________________ Cell Phone ________________________________- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -If your son/daughter has NOT had any pervious experiance please note that here: YES NOIf your son/ daughter has pervious piano experiance please let me know here:Please List of any former Piano Knowledge that your son/daughter knows_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What Grade is he or she in? ___________________What books have they use? _________________________________________LESSON SELECTION AND OPTIONAL TIME AND DAY REQUESTCheck off the one you wish to have30 Minutes _______ 45 Minutes _________ 60 Minutes __________Sunday ________ Tuesday _________ Wednesday __________ Friday ____________
Possible Time Requesting _______________________________