ACTIVATOR MUSIC ACADEMY

Fun Music Lessons Exclusively for Residents of Lake Forest, Lake Bluff, & Knollwood -INSPIRING YOUTH SINCE 2001

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NEW STUDENT INQUIRY FORM

How did you hear about us?
When would you like to begin?
- Start Today!
- Next Month
Student Name
Student Age
Student School
Parent Name(s)
Parent E-mail
Parent Cell Phone
Home Phone
Instrument(s) and/or Class
- Piano
- Guitar
- Drums
- Voice
- Bass
- Strings (Violin, Viola, Cello)
- Band Coaching
- Beginning Group Guitar
- Rock Jam 101
- Songwriting
Available Day(s) *select all that apply
- Monday
- Thursday
Preferred Time(s) *select all that apply
- 2:00-3:00 pm
- 3:00-4:00 pm
- 4:00-5:00 pm
- 5:00-6:00 pm
- 6:00-7:00 pm
- 7:00-8:00 pm
- Other
Preferred Instructor *select all that apply
- Tony Porter (violin, viola, cello, bass, string ensemble online only)
- Sam Subar (drums,Piano)
- Michael Salgado (jazz & rock guitar, bass, piano, vocals)
- Danny Potter (guitar, bass & piano)
- Help Me Choose!
Questions or Comments?
Submit

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Refer a Friend and Receive a FREE Lesson!

Referrals have been critically important to the outstanding growth of our organization over the past 22 years. Refer a friend to Activator Academy today by filling out our quick Referral Form. If they enroll for at least 1 month of lessons, you will receive 1 FREE lesson! There is no limit to the number of FREE lessons you can receive...so please help us spread the word about Activator Academy!

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