Request a Lesson - Lucia Piano Class

Student Full Name *

Student Age *

If your student has a CM certificate, please select what is the highest level.

Parent Full Name (For Emergency Contact) *

Parent Address (For Emergency Contact) *

Parent eMail Address (For Emergency Contact) *

Parent Phone Number (For Emergency Contact) *

Message

Woulld you like to take a trial lesson?

Trial lesson includes lesson and consultation.

Select desired lesson time *

Request a Level Test

(Very beginner level students who have never taken lessons cannot apply for the level test.)

Select your first preferred day of week *

Select your first preferred time of day *

Select your SECOND preferred day of week

Select your SECOND preferred time of day

Select your THIRD preferred day of week

Select your THIRD preferred time of day

(Class days and times may be adjusted in consultation with the teacher.)