Private Music Lesson Application Form

This form must be completed by all students requesting secondary and non-major private music lessons. It is to be submitted before the first day of classes. If you are assigned a lesson you will be registered by the Music Office.

(NOTE: Students interested in Voice lessons should go to to the Voice Study information page instead of filling out this form: https://music.psu.edu/admissions/voice-study)

Name *

Major *

Local Phone *

Semester Standing *

PSU ID# *

Email *

Instrument you are requesting lessons on *

Lesson Length Requested *

Half Hour

Hour Lesson

Number of years of Private Study Prior to Enrollment at PSU *

IF YOU HAVE PREVIOUSLY STUDIED MUSIC AT PENN STATE, FILL IN THE FOLLOWING

Course Numbers Or Instruments

Penn State Instructor's Name

# of semesters

PLEASE LIST TWO PREFERRED LESSON DAYS AND TIMES BELOW

First Choice *

Second Choice *

PLEASE FILL IN TIMES THAT YOU ARE IN CLASS (please note beginning and ending times)

Your acceptance as a student is determined by: (1) School of Music approval, and (2) Faculty availability at the time you are free for a lesson.

Piano lesson appointments will be posted on the bulletin board across from the music office (233 Music Building I). All other lessons will be posted outside the applied instructor's door by the 4th day of classes. You are responsible for checking the posting to obtain the name of your instructor and setting up the lesson time.

Music fees are to be paid at the Bursar's Office, 103 Shields Building, upon receipt of the bill. ($175 FOR HALF HOUR AND $250 FOR AN HOUR LESSON. This fee is an addition to your tuition.)

THE MUSIC FEE REFUND POLICY IS AS FOLLOWS: You will be charged for the number of lessons you received.

PIANISTS ONLY - Please list three recent examples of repertoire studied or performed

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