Registration

Registration Form - Adult Student

* Indicates required field

Student's Name *

First

Last

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Occupation *

Total amount of piano study to-date? (1 year, 5.5 years etc.) *

Degrees? *

Name(s) of previous piano teacher(s) *

Performance Experience *

Do you play (or have you played) other instruments? If so, which one(s)? *

Any hobbies? *

What are some of your goals for piano study? *

Have you ever played in a piano recital? *

Yes No

Have you ever experienced tension in your fingers/hands/arms while or after playing? *

Have you ever experienced technical or musical frustration? (Clarity or speed of passagework? Leaps? Chords? Tonal control? etc.) *

Are you familiar with The Taubman Approach? *

How did you hear about Birmingham Piano? *

What type of instruction are you interested in? *

In-person Private Instruction (Birmingham, AL) Virtual Combination of In-Person + Virtual En locale (workshops and lessons in my city)

Submit