Music Lessons in Your Home
 

If you are interested in learning more about taking piano lessons in the greater Chicago area, please complete and submit the form below or contact us by phone:
:: Your name:
:: Your E-Mail address:
:: Telephone Number:
:: Instrument that I am interested in:
If other please specify:
:: How did you hear about us? ( Please be specific )
*
:: What school does your child go to?
*
:: Mailing Adress
*
:: Do you have your own instrument?
:: For Children does your child have any learning disability?
:: If Child is Under 18 - How old is your Child/Children
:: If Child is Under 18 - Who will be present in the home during the lessons?
*** NOTE there must an adult over the age of 18 home during the lesson.
:: Have they had lessons before?
If Yes, how long -
and with whom -
:: Please Mark All Possible Lesson Days and Times Below:

Blocks of Time
Mon.
Tue.
Wed.
Thurs.
Fri.
Sat.
Sun.
9-12 A.M.
12-3 P.M.
3-6 P.M.
6-9 P.M.
:: How important to you is the following:
Cost of Teacher: Cost of Teacher:
(use check box on a scale of 0 to 10) (10 being very important)

:: Teacher teaching style (check one)

Classical Jazz Suzuki Traditional flexible

:: Comments:

* Required Field

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© Copyright 2004 Music Lessons In Your Home - Piano - Guitar - Violin - Voice & More

777 N. Halsted st., Chicago IL 60622 - Located in River West

Lincoln Park, Gold Coast, Edgewater, River North, The Glen, Wrigleyville, Bucktown, Whicker Park,
Old Town, Oldtown, Ukranian Village, South Loop, River West, Downtown, Uptown, Ravenswood, Depaul, UIC