STUDENT MUSIC EDUCATION REGISTRATION FORM Please Fill Out the Form Below Please enable JavaScript in your browser to complete this form.Student Name *Gender *Select genderMaleFemaleAge *Time Zone *Select your time zonePSTMTCTESTEmailPhone *Parent/Guardian NameParent/Guardian Phone *Preferred Class MethodSelect MethodFacetimeZoomWhatsappGoogle MeetCountrySelect CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsState *Location *Enrollment for lessons *I am enrolling in REMOTE LESSONSI am enrolling in HYBRID LESSONS (Las Vegas Only)Class Duration for Remote Lessons *Single 30 minute Remote lessons - $25 per lessonSingle 45 minute Remote lessons - $40 per lessonNumber of Lessons *Select Number of Lesson1 - $ 25.002 - $ 50.003 - $ 75.004 - $ 100.005 - $ 125.006 - $ 150.00Number of Lessons *Select Number of Lesson1 - $ 40.002 - $ 80.003 - $ 120.004 - $ 160.005 - $ 200.006 - $ 240.00You can choose to do remote lessons and single physical lessons monthly, as many or as few as you need. Remote LessonSingle 30-minute Remote lessons per month - $25 per lessonSingle 45-minute Remote lessons per month - $40 per lessonNumber of Lessons *Select Number of Lesson1 - $ 25.002 - $ 50.003 - $ 75.004 - $ 100.005 - $ 125.006 - $ 150.00Number of Lessons *Select Number of Lesson1 - $ 40.002 - $ 80.003 - $ 120.004 - $ 160.005 - $ 200.006 - $ 240.00Physical LessonSingle 30-minute Physical lessons per month - $30 per lessonSingle 45-minute Physical lessons per month - $45 per lessonNumber of Lessons *Select Number of Lesson1 - $ 30.002 - $ 60.003 - $ 90.004 - $ 120.005 - $ 150.006 - $ 180.00Number of Lessons *Select Number of Lesson1 - $ 45.002 - $ 90.003 - $ 135.004 - $ 180.005 - $ 225.006 - $ 270.00We will contact you shortly to schedule the Private Lesson. Time Slot 1 *DateTimeTime Slot 2 *DateTimeTime Slot 3 *DateTimeTime Slot 4 *DateTimeTime Slot 5 *DateTimeTime Slot 6 *DateTimeTotal Cost$ 0.00Payment *CardName on CardSubmit