Apply Now

Please, complete the form below only after you have had an interview with me. Please, contact me to set up an interview.

Student's Name

First Name

Last Name

Parent's/Guardian's Name

Required for Preschool and Grade School Students

First Name

Last Name

Parent's/Guardian's Name

First Name

Last Name

Primary Email

Secondary Email

Primary Phone Number

Country

(###)

###

####

Secondary Phone Number

Country

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Student's Information

Date of Birth

YYYY

Age

Grade (if applicable)

Anything Else You Would Like Me to Know

Length of Lessons

Username

Password

This is your password to get into your membership page and make payments. I will be able to see this password, so don't put one that you use other places.

Referral

Please, let me know if someone referred you to my studio

Check

I agree to the terms and conditions of Hannah Dye's Piano Studio