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"Without craftsmanship, inspiration is a mere reed shaken in the wind." Johannes Brahms

Student's First and Last Names*

Student's Birthday*

Name of the School (if not attending, write None)*

Parent or Guardian's Name*


Phone Number*

Email Address*

Instrument (if you are taking more than one instrument, please check all that apply)*

Specify Instrument

Lesson Type (check all that apply)*

Lesson Length (check all that apply)*

How did you hear about EMA?*

If Other, please let us know how you found out about us:

Additional Comments or Questions:

Select Your Payment Method (lessons will not be given until after the payment has been received)*

Please check before submitting*

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