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Student Placement Form for Individual Lessons

Thank you for your interest in lessons at MacPhail!

Email*

First Name*

Please provide your first name.

Last Name*

Please provide your last name.

Are you submitting this for form for yourself or for another person?*

I am completing this form for myself

I am completing this form for a child or another person

Phone number*

This will only be used to contact you about your lesson placement.

Preferred contact method*

Call

Student Date of Birth*

Month/Day/Year

Student's Pronouns

Street address*

Street address 2

City*

State/Region*

Zip code*

At which site do you want to have your lessons?*

PLEASE NOTE: Some instruments may only be available at select locations. Many teachers offer both in-person and online instruction. If you are interested in a hybrid schedule, please select the site where you would prefer to attend the in-person lessons.

Minneapolis

Apple Valley

Austin

Chanhassen

MacPhail Live Online

What instrument are you interested in taking lessons?*

PLEASE NOTE: Students are responsible for providing their own instrument.

What styles or genres of music are you / your child interested in studying? (Examples: Classical, Folk, Jazz, Pop, Rock)*

Please tell us about your / your child’s experience with music.*

Could you tell us about your/the student's learning style or any important characteristics of your ideal teacher?

Do you have a need for instructional adaptations, accommodations or modifications?

Schedule and Availability

Please describe your weekly lesson availability below. Include your specific start and end time availability, and any scheduling conditions that we should be aware of. Type "NA" if you are unavailable on a day. Please note that hours vary by site, season, and instructor.

Mondays*

Tuesdays*

Wednesdays*

Thursdays*

Fridays*

Saturdays*

Sundays*

Are any of the following true? (You may choose more than one.)

I/we will be applying for MacPhail Financial Aid or a scholarship.

I/we currently receive MacPhail Financial Aid.

I/we am a MacPhail Scholarship recipient

I/we have a Musical Passport from our school.

I/we are interested in Minnesota Afterschool Advance.

Edit Please use the space below to add any additional comments, considerations or requests to effectively place you / the student into lessons (for example: special needs, other primary language, teacher gender preference, scheduling restrictions, specific goals, future starting date, etc.)?