Student Name *

First Name

Last Name

Parent Name

Leave Blank if these lessons are for an adult

First Name

Last Name

Phone *

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Preferred Day(s)? *

Check any that may apply. We will do our best to find a time that fits your preferences.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Interested in discounted lessons with a junior instructor?

Junior Instructor Program is a new mentorship program here at The Rock Underground Music School aimed at providing advanced students with teaching opportunities as well as discounted lessons for beginner students interested in taking their first lessons. Visit https://www.rockundergroundmusic.com/junior-instructor-program for more information. Link also located below form.