Register | Anna Peszko - Piano Teacher

New Student Registration

To be completed only after booking your first piano lesson.

Is this the first time you have booked a lesson with me?

Yes

I am required to keep records of my pupils for business purposes. Please complete your details below.

First Name *

Last Name *

Pupil Name

If you have booked the lesson for a child under 16 years, please enter their name here.

Date of birth *

Data of Birth is needed for entry into ABRSM exams. Please enter the pupil's date of birth.

Phone number

Mobile number *

I will use your landline and/or mobile phone number to contact you about lessons or, if you have left a child with me and, there is an emergency.

Email address *

I will use your email address to communicate with you about the lessons you have booked and to answer any questions you ask between lessons.

Student Newsletter *

Yes, please

No thanks

I also publish a Students Newsletter that contains general tips and advice about your piano education. Would you like to subscribe?

Address Line 1 *

Address Line 2

Town / City *

County *

Postcode *

About you *

Please tell me a little about yourself; do you play already, can you read music, do you have a piano at home... that type of information. This will help me plan your lessons.

In that case, thanks for booking with me again!

If you are human, leave this field blank.