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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 >
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Thanks - Storm Stenvold
GuitarTeacher.com