Dr. Kathleen Bondurant - Professional Music Instructor

Dr. Kathleen Bondurant - Professional Music InstructorCONTACT INFORMATION

If you would like to receive information on enrolling your child for lessons, please complete the following short questionnaire:

PROSPECTIVE STUDENT QUESTIONNAIRE
[Please go here for detailed information about webcam lessons. Thank you!]

Name of Student:

Age of Student:

Instrument:
Flute Piano Guitar
Vocal or Instrumental Coaching

Name of Parent (if applicable):

Address:

City, State, Zip:
,

Home Phone:

Work Phone:

Cell Phone:

Best time to call:

Email Address:

Reason for Taking Lessons:

Your Goals:

Times you are available for lessons: (Specify Time Zone.)

Questions / Comments: