Lesson Enquiry — State Street Academy of Music

Lesson Inquiries

Please fill out the following form to enquire about State Street Academy of Music's programs. Thank you for your time!

Make sure you have read the Tuition policy agreement

Student's Name

First Name

Last Name

Parent/Guardian's Name

If student is under 18 years of age

First Name

Last Name

School and District

If you are an adult no longer attending school, please list n/a for the school fields

Grade

Email Address

Phone

(###)

###

####

Preferred method of contact

Phone

Both

What instrument(s) does the student wish to study at SSA?

List the student's prior music experience (if any).

I have read the Tuition Policy Agreement

Yes