John Patrick Douglas Music Studio

Registration

PLEASE READ THIS: Before filling out this registration form, please review the Studio Policy page. YOUR REGISTRATION CONSTITUTES YOUR AGREEMENT TO ABIDE BY THESE POLICIES. Please contact me with any questions about the policies. To register, click the appropriate button to select whether you are an adult student or or the parent of a student and fill out the resulting form. Please review the "Equipment and Materials" page for a list of items you'll need to get started. Invoices and some other communications will come from "no-reply@duetpartner.com." Please configure your email system to accept emails from that address.

Are you an adult student or the parent of a student?

I am a(n)

Adult Student Information

First name *

Last name *

Email *

Website URL *

Phone *

Alternate Phone

Birthday (example: mm/dd/yyyy)

School *

Street *

City *

State/Province *

Zip/Postal Code *

Country *

Login Details

Username *

Password *

Verify Password *

*You will not be able to login until your teacher has activated your account.

Parent Information

First name *

Last name *

Email *

Website URL *

Phone *

Alternate Phone

Street *

City *

State/Province *

Zip/Postal Code *

Country *

Login Details

Username *

Password *

Verify Password *

*You will not be able to login until your teacher has activated your account.

Student Information

First name *

Last name *

Phone

Birthday (example: mm/dd/yyyy)

School *

Login Details

Username *

Password *

Verify Password *

Additional Information

What goals or objectives do you plan to achieve by taking private lessons? Will you practice regularly to reach those goals?

How will you know if you've met your goals or objectives?

What music do you listen to for fun?

How frequently will you practice your instrument at home? Is there a quiet place in your home, preferably with a chair (armless) and a music stand, where you can practice on a regular basis?

By checking the box and clicking 'Register" you agree to our studio policy.