Email Address:

First Name:Last Name:

Address:

Address Line 2:

City:State/Province:

Country: Postal Code:

1) Most interested in:  Fundamentals  Music Theory  Skills and Composition  Playing Songs  Other

Other explain:

2) Music preference (style):

Blues Jazz Fingerstyle Blues Alternative Grunge

Classical Country Gospel Southern Rock Latin Rock Metal

Fingertyle Country Surf Classic Rock Pop Southern Gospel

Acoustic Rock Folk Country Fingerstyle Fingerstyle Jazz Punk

Christian Praise Boogie R & B Country Rock Bluegrass Other

Other Explain:

3) Current Stage level: (To determine current Stage level complete the Moving Toward Great Guitar Playing Questionnaire.)

   (Beginner)

Level 1 Level 2 Level 3 Level 4 Level 5 Level 6 Level 6+

4) In which rhythm style are you most interested:

5) In which lead style are you most interested:

6) Are you a: Guitar Hobbyist Guitar Instructor Professional Performer

Student with Professional Aspirations

7) Do you prefer: Songs with Vocals Instrumentals Both

8) Are you a vocalist: Yes No Working on It

9) Do you currently play with other musicians: Band Church Friends Solo Act

Description:

10) How many years have you been playing guitar: 

Consistently Off and On

11) If it applies, how much time do you practice daily: 

12) If you know, what are your guitar playing goals:

13) If it applies, what are the strongest aspects of your current music ability:

14) Are there specific points of interest that you would like to work on:

Technique Theory Transcribing Dexterity Notation Ear Training

Rhythm Lead Composition Ad Lib Putting It All Together

Other: 

15) Do you currently play any other musical instruments: Yes No

If yes, what instrument/s and how long have you been playing: 

16) Have you played any other musical instruments in the past: Yes No

If yes:

What instrument/s? 

How long ago? 

How long did you play? 

17) Are you currently taking music instruction of any kind: Yes No

If yes:

What instrument or study? 

How long? 

18) Do you play: Electric Acoustic Both

19) Favorite Artists: 

20) If it applies, are there specific songs you would like to learn:

21) Which do you think best describes you: Beginner Intermediate

Intermediate but Would Like to Start from Beginning Advanced

Comments:

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