Application Form

Give youself or your loved one the wonderful gift of singing to warm up the holiday season!
Fill out this online application form (no obligation) and contact me to schedule your FREE* trial voice lesson! (*Offer may expire without prior notice)

I would like to get to know you better and build a program to suit your personal needs. Please fill out this online application form (no obligation) before your first free lesson.

Required fields are marked with a red asterisk (*).

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Personal & Contact Information

Name:*
Gender: Female  Male
Birthday:   
E-mail:*
Phone/s:
Address:
Address (cont):
City:
State / Province / Region:
Postal / Zip code:
Country:
                                     

Musical Background

Do you play a
musical instrument?
Reading notes skills: Strong  Some  None
Writing notes skills: Strong  Some  None
Sight singing skills: Strong  Some  None
Piano skills: Strong  Some  None
Do you have a musical
instrument/s at home?
Additional information:
                                     

Singing Background

Vocal training
or RCM grade:
Vocal experience:
Choral activity:
Role model/s:
Preferred musical style/s:
Song/aria you’d
like to work on:
Vocal goals:

what are your goals for the
short/medium/long term
Interested in RCM
examinations? 		Yes  Not Sure  No    About RCM examinations
Additional information:
                                     

Health Issues

Click here for additional information on vocal health
Voice problems

past/present:
Do you smoke? Yes  Sometimes  No
Last visit to laryngologist:   
Heartburn/reflux: Yes  Sometimes  No
Allergies:
Special medical
conditions:
Medications taken regularly:
                                     

Submit Application Form

Preferred days/times:

including weekends
Where did you hear
about the studio?
Additional comments:
Please read before submitting this application form:*   (Required) By clicking ‘Send Application Form’ the student understands that in order to demonstrate, the teacher might occasionally touch the student and/or ask the student to touch the teacher in the abdominal/dorsal or head/neck areas. Usually the teacher will ask for permission before touching, but at any point that the student feels uncomfortable she/he must say so immediately and the teacher will stop.
Terms & Conditions:  By clicking ‘Send Application Form’ you agree to the Studio Policies and the Privacy Policy.
                                     

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