Name
Post Code
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Address
Phone Number
Mail Address
Mail Address Confirm
Gender
Men
Women
Date of Birth
ex):0000/00/00
(if you are under age 20.)
Guardian's Name
(if you are under age 20.)
Address
(if you are under age 20.)
Phone Number
(if you are under age 20.)
Mail Address
(if you are under age 20.)
Mail Address Confirm
(if you are under age 20.)
School
Your Profile
Lesson
A・Piano solo lesson
B・Chamber music lesson
A.B・Both
Do you need interpreter
A・English
B・Japanese
C・French
D・English&French
Pieces you would bring
to the lesson.
※Please fill out the details about the composer and the name of a piece.
Remarks Column
Instrumental Setting (Please fill out the name of your partner(s) and instrument(s) in the remarks column below.)