Referred Student Form

You get free lessons, they get free lessons, the world gets another musician. It's a win-win-win.

Your First Name

Your Last Name

Your Email *

Your Phone *

Student is...

A Child
An Adult
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Child's First Name

Instrument (optional)

Piano
Guitar / Ukulele
Voice
Multiple / I'm not sure
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Preferred Location (optional)

Downtown Decatur
Hapeville
Not sure
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___________________________________________________________________________________________________________________________________

Referee You First Name *

The person who referred you

Referee Last Name *

Referee Email (optional)

Referee Phone (optional)

I agree that by providing my email address and phone number, I consent to receive communication from the business, including automated text messages. We will attempt to contact you up to three times after submitting this form.

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