New Student Information Page
Student Information
Name:
Email:
Phone #:
Where do you live?:
Age:
Under 12
Teens
20's
30's
40's
50's or over
What is your internet connection speed?
Dial up
Cable
DSL
Do you have a webcam?
Yes
No
Please list days and times (your time) you are available for lessons:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Mornings
Afternoons
Evenings
Do you have an ideal day and time for your lesson?:
Player Profile
Important… Please don't
let this form scare you, this is just to help me understand where
you need help. Please take the time to fill it out to the best of
your ability. If you are unsure about something just leave it blank.
The most important question on this form is at the bottom, so spend
the most time on that. Thank you.
How long have you been playing guitar for?
What type of guitar or (guitars) do you play?
Do you play (or want to play)
Lead
Rhythm
Both
Select all the styles that you like
Rock
Blues
Metal
Jazz
Country
Folk
Pop
Fusion
Acoustic
Classical
Please explain which of
the styles (that you selected above) that you would like to learn and why.
Have you taken guitar lessons in the past or are you taking them now?
Yes
No
Please check all the Major
chords you can play
A
B
C
D
E
F
G
Check all the minor chords you can play
A
B
C
D
E
F
G
What dominant 7th chords can you play?
A
B
C
D
E
F
G
What minor 7 chords can you play?
A
B
C
D
E
F
G
What major seven chords can you play?
A
B
C
D
E
F
G
What minor 7 b5 chords can you play?
A
B
C
D
E
F
G
Can you play using power chords open and movable?
Yes
No
If you answered yes above, on a scale from 1 to 10 rate your
ability
1
2
3
4
5
6
7
8
9
10
Can you play any barre chords?
Yes
No
If you answered yes above, on a scale from 1 to 10 rate your
ability
1
2
3
4
5
6
7
8
9
10
Check all the chord types that you know. If you're not sure, leave
them blank.
Major
Maj
Maj6
Maj9
Maj7b5
Maj7#5
Dom7
Dom7#9
Dom7#5
Dom7sus4
Dom7b5
Dom9
Dom7b9
Minor7
Min6
Min9
Minor
Min7b5
Aug
9/6
Dim
Dim7
Dom13
Do you know your Triads going up through the inversions on the 4 sets of
3 strings?
Yes
No
To the best of your ability
explain all your chord knowledge
Can you use alternate picking?
Yes
No
If you answered yes above,
on a scale from 1 to 10 rate your ability (10 is great)
1
2
3
4
5
6
7
8
9
10
Can you use hammer-on, pull offs and bends?
Yes
No
If you answered yes above, on a scale from 1 to 10 rate your
ability
1
2
3
4
5
6
7
8
9
10
Can you play a Major scale?
Yes
No
If you answered yes above, on a scale from 1 to 10 rate your
ability
1
2
3
4
5
6
7
8
9
10
Can you play all of the patterns from the Major scale and connect them?
Yes
No
If you answered yes above, on a scale from 1 to 10 rate your
ability
1
2
3
4
5
6
7
8
9
10
Can you play a pentatonic scale?
Yes
No
If you answered yes above, on a scale from 1 to 10 rate your
ability
1
2
3
4
5
6
7
8
9
10
Can you play all five
pentatonic scale patterns, and connect them?
Yes
No
If you answered yes above,
on a scale from 1 to 10 rate your ability
1
2
3
4
5
6
7
8
9
10
To the best of your ability explain your scale knowledge and how you use
it?
Please check what you would like to work on (this will
just give us an idea)
Rhythm
Soloing
Songs
Playing scales
Chords
Theory
Basic technique
List some of the songs
that you can play
List some songs that you might like to work on
List your favorite guitar players
Briefly describe your goals as a guitar player
How many days a week can you practice?
1
2
3
4
5
6
7
How much time each day can you allow yourself to practice?
15 to 30 minutes
30 to 45 minutes
45 minutes to 1 hour
1 or more hours
Please explain (only if you can) what
you would really like to work on this month. This question
is what we really look at…
If everything is filled out and
correct click here >
or
Thanks - Storm Stenvold
GuitarTeacher.com
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