MARYVILLE ROCK ACADEMY
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Student First Name
Student Last Name
Parent Name (if student is under 18 years old)
Phone (or Parent's Phone if student under 18 years old)
City, State ZIP
What would you like to accomplish with your musical skills?
Learning My Favorite Songs
Becoming a Confident Musician
Performing in Front of Other People
Writing My Own Songs
Being Part of a Band
Do you have any musical experience?
I'm brand new to learning music
I've studied music, but it's been awhile ago
I'm currently learning music in school (K-12 or college)
I'm currently taking music lessons from another music school
I currently play in a cover band
I currently perform my original music in public
I've performed music in public before, but it's been awhile ago
Your Favorite Musical Artists and/or Songs:
What Metal Skills Do You Want To Develop?
Metal Vocals (singing and screaming)