Private Lessons Private Lesson Registration Form Fill out this form as completely as you can and we will call you to confirm your request and schedule a lesson. Student InformationName* First Last Age*Instrument*Lesson Format:In-Person lessons on site at Taylor'sRemote lessons*Please note: any changes to your lesson format must be sent to firstname.lastname@example.org*Instructor PreferencePreferred Day/TimeTake a moment to describe the student's level of experience and stylistic preferences. This will help us match you with an instructor.Customer InformationName* First Last Email* Enter Email Confirm Email Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Phone Number*Secondary Phone NumberCredit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Registration Fee* Price: $25.00 Coupon Total $0.00 CCCOVID-19 Policy Notice* I have read the Taylor's COVID-19 Policy effective 8/16/21 and understand that it may change according to guidance from the CDC, at which time I will be notified by Taylor's. By checking this box, my child and any other accompanying individuals, including myself, agree to follow these safety policies when or if we are inside Taylor's Music Store. Lessons Agreement* I have read the Taylor's Lessons Agreement below and give Taylor's Music permission to enroll my credit card in monthly autopay once lessons have been scheduled with an instructor. By selecting this box I consent to the Taylor's Lessons Agreement billing and scheduling policies outlined therein. NameThis field is for validation purposes and should be left unchanged.