Name (required)

Email (required)

Phone

How did you find out about CMC? (required)
—Please choose an option—Clicked on Google AdSaw CMC in Google search resultFriend referralSchool flyerMail flyerNextDoorCraigslistFacebookBusiness CardOther

If you chose other, from where did you hear about CMC?

If you were referred by a friend, who may we thank for your referral?

Instrument focus
—Please choose an option—GuitarPiano/KeyboardDrumsBass guitarUkuleleCombination (specify below)

If a combination, of which instruments?

Please select one: (required)
I want to schedule a FREE introductory lesson!I have a question or would like more information.

Who will be taking the lessons? How may I help you?

Which day(s) and time(s) are you available for weekly lessons?
Please check ALL available times. The time slots below are for grade-school students (2nd through 12th, some 1st grade exceptions). However, there are also a few slots available midday for adult students. Contact me for the current midday slot availability.

Mondays       3:40-4:30p4:35-5:25p5:30-6:20p

Tuesdays       3:40-4:30p4:35-5:25p5:30-6:20p

Wednesdays 3:40-4:30p4:35-5:25p5:30-6:20p

Thursdays     3:40-4:30p4:35-5:25p5:30-6:20p

Fridays     3:40-4:30p4:35-5:25p5:30-6:20p

Please list 3 to 5 songs that you (or your children) would love to play.

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Clark's Music Class is located in which state? (please capitalize the first letter)
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