String Lessons Questionnaire "*" indicates required fields Student Name* First Last What is the student's age?*Parent/Guardian (if student is under 18 years old) First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Enter Email Confirm Email Phone*SOURCEHow did you hear about strings lessons with the Griffon String Quartet?* Printed newspaper Online news source Facebook Email Website Google search Other (explain below) OtherLessons QuestionnaireWhich instrument are you applying for lessons?* Violin Viola Cello Do you own or rent your own string instrument?* Rent Own Would you like information on renting an instrument from Midsummer's Music?* Yes No Have you had any private music lessons in the past? (what instrument, who was the instructor, how many years, etc)Are you interested in participating in a monthly studio class for multiple students to play together and perform for each other?* Yes No Are you in need of a scholarship? Please explain.If a scholarship is awarded, the student may be requested to write Thank You notes and participate in special performances.Individual Private Weekly Lessons:30 minutes: $25 45 minutes: $37.50 60 minutes: $50 Payment for complete sessions is required in advance, except in hardship cases, which are addressed on a case-by-case basis.Attendance policy: If the teacher needs to cancel, the lesson will be made up. If the student needs to cancel, 48-hour notice must be given to qualify for a makeup lesson. One makeup lesson will be offered per semester. This does not apply to emergencies.NameThis field is for validation purposes and should be left unchanged. Δ