Student Name

First Name

Last Name

Age

Parent Name (if under age 18)

Phone Number

(###)

###

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Tell us more about yourself and your musical experiences.

How many years have you studied? What are your goals? What have your performance experiences been like? Please include any other relevant details.

Do you have any specific questions or things that you would like us to address in the coaching?

Tell us your schedule availability (please note our office/conservatory hours are Monday through Friday 2pm-9pm, Saturdays 9am-5pm Eastern Time)

LOC Online Piano Coaching