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Student Application Form

Please fill out the following to apply for music lessons:

What type of lessons will you be taking? Required
For piano lessons, we offer online lessons via FaceTime or Skype at a discounted rate from 9am-2pm. Would you be interested? Required
What weekday(s) work for you? Required
What time of day works for you? Required
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Would you allow Pont Breaux Piano to post pictures and video of the student to social media?
What is your preferred means of payment?

Terms Of Agreement

We require that you read and consent to our Terms Of Agreement located above.

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By submitting this application, you verify that all the information in this application is accurate and that you have read and consent to our Terms Of Agreement as posted above:

Application submitted!

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Thank you for choosing Pont Breaux Piano for music lessons! We will get back to you within the next 24 hours with our current lesson time availability and additional info.

© 2023 - Pont Breaux Piano

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