FCC Music Lesson Interest Form

FCC Music Lesson Interest Form
Student Information
Student Name*

First NameLast Name
Student Email*
Daytime Phone*
Are you a new or returning FCC Music student?*

New StudentReturning Student
Have you already coordinated lesson dates & times with an instructor?*

YesNo
Student Age Range*

Elementary (6 to 10 years)Middle School (11 to 13 years)High School (14 to 18 years)Adult (19 years+)
If applicable, please indicate if you are

A Dual Enrollment StudentAge 60 or over
Music Instrument
Please select your instrument for lessons

BassBassoonCelloClarinetEuphonium/BaritoneFluteFrench HornGuitarOboePercussionPianoSaxophoneTromboneTrumpetTubaViola/ViolinVoice
Do you wish to take lessons for more than one instrument?

NoYes
Additional Instrument - Please provide the details for your additional instrument(s) below and Dr. Mike Gersten will contact you separately regarding lessons for the additional instrument(s).
Thank you for providing that information. Dr. Mike Gersten will contact you to arrange those lessons. Please continue below to complete the remainder of this form in regards to your initial request for {2Please} lessons. ↓ Thank you!
Music Instructors
Instructor Selection Information
Bass Instructors

David Lester - BassDavid Lester - Bass GuitarNo preference
Bassoon Instructor

AnnaClaire Ballard-Ayoub - Bassoon
Cello Instructor

Adam Gonzalez - Cello
Clarinet Instructors

Meredith Gersten - ClarinetMichael Gersten - ClarinetNo preference
Euphonium/Baritone Instructors

Brandon Carbonari - Euphonium/BaritoneNo preference
Flute Instructors

Jessica Banks - FluteMichelle Rippey - FluteNo preference
French Horn Instructor

Jason Ayoub - French Horn
Guitar Instructors

Chaz Aguado - Guitar ClassicalDavid Lester - Guitar BassPeter Heiss - Guitar Pop/JazzNo preference
Oboe Instructor

AnnaClaire Ballard-Ayoub - Oboe
Percussion Instructor

Greg Herron - Percussion
Piano Instructors

Hsin-Yi Chen - PianoAlice Lee - PianoDavid Loy - PianoLynn Staininger - PianoJohn Wickelgren - PianoDr. Jihna Park- PianoJonathan Kurtz - Jazz PianoNo preference
Saxophone Instructors

Howard Burns - SaxophoneMichael Gersten - SaxophoneNo preference
Trombone Instructors

Brandon Carbonari - TromboneNo preference
Trumpet Instructors

Olivia Malin - TrumpetMax Harrington - TrumpetNo Preference
Tuba Instructors

Brandon Carbonari - TubaNo preference
Viola/Violin Instructors

Jason Diggs - ViolaJason Diggs - ViolinRowell Jao - ViolinMarjory Serrano - ViolinRowell Jao - Violin SuzukiNo preference
Voice Instructors

Mary Gresock - VoiceDavid Loy - VoiceKristianna Pirrie DilworthSterling Scroggins - VoiceLynn Staininger - VoiceNo preference
Music Lesson Schedule
Lesson Schedule Details
Months(s)
Day(s) of the Week
Lesson Duration
Lesson Start Time

ex: 10: 00

AM/PM Option
Lesson Schedule Instructions
Preferred Month(s)
Preferred Day(s) of the Week (in order of preference)
Requested Lesson Duration
Preferred Lesson Start Time

ex. 10: 00

AM/PM Option
Please let us know any additional information regarding your requested day(s) and time(s) above.
Thank You
Student Schedule Approved

YesNo
Assigned Instructor

Aguado, Chaz - Classical GuitarAyoub, Jason - French HornBallard-Ayoub, AnnaClaire - BassoonBallard-Ayoub, AnnaClaire - OboeBanks, Jessica - FluteBurns, Howard - SaxophoneCarbonari, Brandon - Euphonium/BaritoneCarbonari, Brandon - TromboneCarbonari, Brandon - TubaChen, Hsin-Yi - PianoDiggs, Jason - ViolaDiggs, Jason - ViolinGersten, Meredith - ClarinetGersten, Michael - ClarinetGersten, Michael - SaxophoneGonzalez, Adam - CelloGresock, Mary - VoiceHarrington, Max - TrumpetHeiss, Peter, Guitar Pop/JazzHerron, Greg - PercussionJao, Rowell - ViolinJao, Rowell - Violin SuzukiKurtz, JonathanLee, Alice - PianoLester, David - BassLester, David - Guitar BassLoy, David - PianoLoy, David - VoiceMalin, Olivia - TrumpetPark, Jinha, PianoPirrie Dilworth, KristiannaRippey, Michelle - FluteScroggins, Sterling - VoiceSerrano, Marjory - ViolinStaininger, Lynn - PianoStaininger, Lynn - VoiceWickelgren, John - Piano
Assigned Instructor Email
Assigned Day

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Lesson Start Date

MonthDayYear
Lesson End Date

MonthDayYear
Lesson Start Time

ex: 10: 00

AM/PM Option
Lesson End Time

ex: 12: 00

AM/PM Option
Lumens Class URL Link
Student is Registered in Lumens

YesNo
Additional Notes
Dr. Mike Gersten, FCC Music Program Manager
Keep this field here - it's built into the conditions :) Thanks!
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