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New York

Himausiclessons@gmail.com

+1516-967-2774

STUDENT INTAKE FORM

Please take a moment to fill out the form.

First Name

Last Name

Phone Number

Birthday * required

Emergency Contact (if minor):

Have you taken vocal lessons before?

Yes

Do you play any instruments?

Yes

If Yes, which one?

Can you read music?

Yes

Somewhat

Anything else you would like your instructor to know about you?

Voice Type *

Soprano

Mezzo Soprano

Alto

Tenor

Beritone

Bass

Not sure

What do you feel are your voca strengths? (e.g., tone , pitch, stage presence, range , confidence, etc)

What areas would you like to improve? (e.g., breath control, pitch accuracy, range, power, confidence, etc.)

What genres of music do you enjoy singing? (Check all that apply or add your own * Required

Classical

Pop

Rock

Jazz

Musical Theatre

Country

Others

Favorite Artists/ Songs

What would you like to gain from vocal lessons? (e.g., better technique, audition prep, confidence, performance skills, etc.)

Are you preparing for anything specific? (auditions, performances, etc.)

Goal Setting (Please list 3 attainable goals with timelines) [For Example: Goal #1: get better with high notes, target timeline (ex: 4 weeks, 3 months):

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