Assessment Form

I am a:

Parent / Guardian

Student Information

First name:

Bernardo

Last name:

Ortiz

age:

10

Discipline:

Piano

Parent/Guardian Information

First Name:

Ana

Last Name:

Carrillo

Enter Email:

pcarrillo@tsgrep.com

Contact Number:

7782232456

Note:

Bernardo loves piano but he is kind of shy, he already took 2 years of piano lessons in the past. It might help to be in group.