Trent Rhodes Piano Connection
Trent Rhodes Piano Connection
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Application
Students Name *
Students Birthdate *
Students Age *
Students grade (if still in school)
Email address *
Phone Number
Parents Name (if under 18)
Street Address *
City *
State *
Zip *
Preferred method of contact *
Phone
Text
Email
What is the musical history of the family? Are any instruments currently played?
What is the musical experience of the student? (Singing in school, other instruments, etc)
Each lesson is tailored to the student. Please let me know anything that might influence my teaching approach. (Examples: ADD, ADHD, anxiety, autism, dyslexia, depression, eye problems, speech delay, etc.) *
What are your goals in taking piano lessons? *
To play for personal enjoyment
To try something new
For the love of music
To learn a new skill
To accompany (church or other settings)
To perform (alone or with a group)
Cognitive/physical benefits
There is a piano in the home, and someone needs to use it
As a stepping stone to another instrument
To learn a specific song/genre
Another reason not listed
What are your goals in regard to practice? *
No practice
Practice 2 or 3 times a week
Practice 4 to 6 times a week
Random practice
Daily practice
Do you own a piano? *
No, and do not plan on getting one anytime soon
No, but plan on getting one in the next month
Yes, an acoustic piano (spinet, studio, upright, baby, grand)
Yes, a digital piano (88 weighted keys)
Yes, a keyboard (not recommended for long-term
Other, not listed
Tell me about your piano/keyboard
88 keys
Less than 88 keys
In tune
Needs to be tuned
All of the keys work
Some keys do not work
3 pedas
2 pedals
1 pedal
0 pedals
Headphone jack
It has a dedicated bench/stool
Student's favorite type of music or artist?
Do you have any questions for me? Feel free to put them here.
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