Interview Request Form

To schedule a free 30-minute interview / trial lesson with me, please fill out and submit this form:

(* = required)

    Your Name *

    Your E-mail *

    Your City/Town *

    What's Your Role? *

    What's your status? *

    How long have you been studying? *

    Transfer students are required to have the consent of their current teachers to interview. Do you have your current teacher's consent? *
    Yes, I have my current teacher's consent

    Student 1

    Age of student:
    What's their status? *

    How long has the student been studying? *

    Transfer students are required to have the consent of their current teachers to interview. Do you have their current teacher's consent? *
    Yes, I have their current teacher's consent

    Add another student


    Student 2

    Age of student:
    What's their status? *

    How long has the student been studying? *

    Transfer students are required to have the consent of their current teachers to interview. Do you have their current teacher's consent? *
    Yes, I have their current teacher's consent

    Add another student

    Student 3

    Age of student:
    What's their status? *

    How long has the student been studying? *

    Transfer students are required to have the consent of their current teachers to interview. Do you have their current teacher's consent? *
    Yes, I have their current teacher's consent

    Add another student


    Student 4

    Age of student:
    What's their status? *

    How long has the student been studying? *

    Transfer students are required to have the consent of their current teachers to interview. Do you have their current teacher's consent? *
    Yes, I have their current teacher's consent

    List the days and times that would work for you on a regular weekly basis for lessons: *
    (Standard lessons are 60 minutes once a week. 45-minute lessons may be an option for new beginners, or 30-minute lessons for especially young beginners.)

    List specific dates and times when you would be available for a 30-minute interview / trial lesson: *

    Use this space for additional information and/or questions:


    Before submitting, please double check that you've entered your e-mail address correctly! If I don't have a correct e-mail address, I can't contact you 🙂


    If you’re experiencing difficulty with the form, feel free to e-mail me at: stanek (at) pianowithjeff (dot) com and put “Interview Request” in the subject line. Please include your name, interview availability, and weekly lesson availability in the e-mail, as well as helpful background information: ages of student(s) if not adult, status of student(s) (new beginner / transfer / resuming) and prior experience if any.