Consumer Music Online Form

Music
Lesson
Form 		Please complete, print page, and fax or drop off at our store.
Att: BRAD SEARS, 927 Tennessee Street, Vallejo
Phone: 707-642-RENT    Fax: 707-642-7374

At this time, we can only Accept Lesson Forms By Fax or In Person.
*We can also provide a form when you visit the store.
1.  First name: 

2.  Last name: 

3.  Phone number:    Cell Phone: 

4.  Address: 

     
       City                                                                  State                       Zip Code

5.  What Instrumentment(s) Are You Interested In Learning To Play?  


6.  When Would You Like To Start? (Please Include Date ex: March 15th). 


7.  What Day Of The Week Would You Like?
(We cannot guarantee this day, but we will do our best!)

 Monday   Tuesday   Wednesday   Thursday   Friday   Saturday

8.  Time of Day?
(We cannot guarantee a certain time slot, but we will do our best!)

1st Choice:  AM   or  PM        2nd Choice:  AM   or  PM  

9. Are You Interested In?
 Rock      Alternative      Pop      Blues      Jazz    
 Hard Rock      Country      Song Writing      Performing    

Please Briefly Describe What Your Goals Are For Learning Music:
(This will help us match up the best Instructor for you).


Please sign:

If you are under 18 years of age, we will need your Parent/Guardian permission, please have them sign below:
I give my permission for
to participate in music lessons at Consumer Music, 927 Tennessee Street, Vallejo, Ca, 94590. Signed:

Please fax at (707) 642-7374 or drop off at our store. You can also call us at: (707) 642-RENT (7368). If Faxing, please call to notify us of your fax. We Will Also Call and Confirm Receipt Of Your Lesson Form Fax. Thank You!

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