“Discontinue Lessons” Form

Please let us know below if you plan on discontinuing private lessons:

STUDENT INFORMATION

Student's Name

First Name

Last Name

Parent/Caregiver Name

If applicable.

First Name

Last Name

Instructor's Name

Current Day of Lesson

Please select your current lesson day.

Current Lesson Time

Please enter your current lesson time.

Hour

Minute

Second

Phone

(###)

###

####

Reason for Discontinuing Lessons/Comments

Please let us know the reason the student is discontinuing lessons.