Skip survey header

Student Placement Form for Individual Lessons

Thank you for your interest in lessons at MacPhail!

Note: Items with an asterisk are required.

1. Student Information
This question requires a valid date format of MM/DD/YYYY.
calendar
2. Parent / Guardian Information (if applicable)
This question requires a valid date format of MM/DD/YYYY.
calendar
3. Please provide your contact information.
This question requires a valid email address.
This question requires a valid number format.
5.

At which site do you want to have your lessons?

PLEASE NOTE:

  • Some instruments may only be available at select locations
  • Many teachers offer both in-person and online instruction. If you are interested in a hybrid schedule, please select the site where you would prefer to attend the in-person lessons. Learn more about Live Online Instruction.
*This question is required.