Sign Up For Lessons

	This New Student Registration Survey Helps Assist Us In Matching Your Interests and Preferences With An Instructor and in Personalizing Your Lesson Program to Provide You With The Best Possible Experience! Please Fill Out The Survey and a Falcetti Music Associate Will Contact You With Available Times and Days. We Look Forward To Helping You Begin / Continue Your Musical Journey!
	•Lessons Are Offered For All Ages and All Playing Levels •Private Lessons Are 1/2 Hour Every Week •Lesson Rates Are $18-$22 And Are Billed Out Monthly •A 1 Time $19.95 Registration Fee Applies •No Long Term Commitments, Just A One Month Discontinuation Notice •Our Successful Band Programs Are Now Open To Outside Participants, As Well As Current Falcetti Music Private Students •Rental Instruments Available For Certain Areas Of Study
Student First and Last Name (*)	Please Type Student's Full Name.
	Birth Date
Month (*)	010203040506070809101112 Invalid Input
Day (*)	12345678910111213141516171819202122232425262728293031 Invalid Input
Year (*)	19501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042004200520062007 Invalid Input
Responsible Billing Party (*)	If billing contact is the student, type SAME
Your Email Address (*)	Please Enter A Valid Email Address.
Mailing Address (*)	Please enter a valid mailing address.
City/Town (*)	Please Enter Your Town
Zip Code (*)	Please Enter a Valid Zip Code
Cell/Work Phone (*)	Please Enter a Valid Phone Number
Home Phone (*)	Please Enter a Valid Phone Number
What Kind Of Lessons Do You Want To Take? (*)	AccordionBanjoBaritoneBass GuitarClarinetDrumsFluteFrench HornGuitarMusic For TotsOrganPianoSaxophoneTrumpetUkuleleViolinVoice Invalid Input
Do You Have Your Own Instrument? (*)	YesNo Invalid Input
If So, What Kind Of Instrument Do You Practice On At Home?	I don't own an InstrumentElectric GuitarAcoustic GuitarBass GuitarDigital PianoAcoustic PianoKeyboardOrganDrumsetHand DrumsViolinBanjoMandolinSaxFluteClarinetAccordionUkulele Invalid Input
Did You Buy It From Us?	YesNo- Invalid Input
Do you have a free lesson coupon? (*)	yesno Invalid Input
	Please List your favorite bands/styles of music here:
Favorite Music (*)	Please Type Your Favorite Music.
Have You Taken Lessons or Do You Have Any Playing Experience?	YesNo Invalid Input
As a player, I am:	A BeginnerIntermediateAdvanced Invalid Input
What Are Your Goals For Music Lessons? (*)	Playing For Fun Technique, Music Reading, etc...Both Above Invalid Input
	Please list all days and times you're available for lessons here:
Your Availability (*)	Please enter days and times you're available.
How did you hear about us? (*)	Invalid Input
	Terms and Conditions: I understand there is a one time $19.95 registration fee, lessons are payable at the beginning of each month (a $10.00 late fee will be charged by the 15th if not paid), and there is a one month notice required to discontinue lessons. I accept these terms
(*)	Yes, I AgreeNo, I DO NOT Agree Invalid Input
	Please review your registration form and make sure that all of the required (*) fields have been completed!