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Piano Placement Form
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Student's Last Name
*
Student's First Name
*
Age as of September 1st (or Adult)
*
Grade in school this coming fall (if applicable)
Parent/Guardian/Adult Student name(s)
*
Phone Number
*
E-mail Address
*
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I/my child would like to start lessons in
*
Fall
Spring
Summer
Please note that placement is dependent on availability.
Desired lesson length (We recommend beginners select 30 min.)
*
30 min.
45 min.
60 min.
Unsure - will confirm at placement
Did you register for Individual Instruction lessons through the Peabody Preparatory during the past school year?
*
Yes
No
Years of playing experience
*
Please list recent repertoire you have studied (if applicable)
*
Please check your preferred campuses for lessons
*
Downtown Baltimore
Towson
Annapolis
Howard County
Frederick
Available times
*
Please list all possible windows of time that you are available for lessons. Please note that openings are limited, and we may not be able to place everyone.
Name
This field is for validation purposes and should be left unchanged.
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