Stephanie James Piano - Registration

Registration

If you are interested in lessons please fill out the following and I will contact you very shortly.

Are you an adult student or the parent of a student?

I am a(n)

Adult Student Information

First name *

Last name *

Email *

Website URL *

Phone *

Alternate Phone *

Birthday (example: mm/dd/yyyy)

School

Street *

City *

State/Province *

Zip/Postal Code *

Country *

Login Details

Username *

Password *

Verify Password *

*You will not be able to login until your teacher has activated your account.

Parent Information

First name *

Last name *

Email *

Website URL *

Phone *

Alternate Phone *

Street *

City *

State/Province *

Zip/Postal Code *

Country *

Login Details

Username *

Password *

Verify Password *

*You will not be able to login until your teacher has activated your account.

Student Information

First name *

Last name *

Email *

Birthday (example: mm/dd/yyyy)

School

Login Details

Username *

Password *

Verify Password *

Additional Information

What are your goals for lessons?

How old is the potential student? Adult? Teen? Elementary? Pre-School?

When are you looking to start lessons?

By checking the box and clicking 'Register" you agree to our studio policy.