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KOOKY KOALA MUSIC
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Name
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Student Name
*
Student age
*
Email
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Choose any of the following options
Group Keyboard Lessons
Group Guitar Lessons
Individual Piano/Keyboard Lessons
Individual Guitar Lessons
Preferred Lesson Time (If known)
Monday after school
Tuesday after school
Wednesday after school
Thursday after school
Student is home schooled
Do you want to have lessons with a friend or sibling?
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No
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Has the student ever had music lessons before? If yes, please add details
*
Anything else you would like to add/ask
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