“Lesson Change Request” Form

Please let us know any changes you would like to request to your lesson day and time.

Please fill out this form for each student and/or private lesson you are requesting a time change for.

We will make every effort to accommodate your request. Completing this form helps speed up the process!

STUDENT INFORMATION

Student's Name

First Name

Last Name

Parent/Caregiver Name

If applicable.

First Name

Last Name

Instructor's Name

Current Day of Lessons

Please provide the day of your regularly scheduled lesson.

Current Time of Lesson

Please provide the time of your regularly scheduled lesson.

Hour

Minute

Second

Phone

(###)

###

####

Change Request

Please describe the change you would like in your lesson day or time.

Please Acknowledge the Following Statement:

I understand that any possible changes will be made on a rolling basis and are subject to availabilty.