Thank you for your interest in private music lessons at the Capitol Hill Arts Workshop! Please answer the following questions to help us match you with one of our Teaching Artists.

Are you interested in lessons for an adult or youth student?

First Name

Last Name

Address

City

State

Zip

Phone (home)

Phone (mobile)

Phone (work)

Parent/Guardian Information:

First Name

Last Name

Address

City

State

Zip

Phone (home)

Phone (mobile)

Phone (work)

Relation

Student Information:

First Name

Last Name

Date of Birth

Instrument:

Cello
Flute

Guitar
Harp

Piano
Violin

Viola
Voice

What days and times are you available for lessons?

Please describe any previous music experience the student has:

What is the student's goals in taking private music lessons?

Questions for Grant-Writing Purposes

Student's Race/Ethnicity

Gender

Have you taken classes or music lessons at CHAW before?

How did you hear about CHAW?

BUILDING
COMMUNITY
THROUGH THE ARTS.

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545 7th Street, SE
Washington, DC 20003

t/ 202-547-6839
f/ 202-543-1723

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