Registration – PRV

2024-25 Time Slot Request Form (Portage)

This form is for students who are looking to sign up for lessons at our Portage location.

For Osborne, please us this form.
For online lessons, please use this form.

Your Name *

First

Last

Contact Information *

Phone *

Number of Students *1234

If you are signing up for 5 or more students, please call 204-231-1677 and we will be glad to help you with that.

Student #1 *

First

Last

Instrument(s) *

Lesson Length *

• 30 minutes ($26)
• 45 minutes ($39)
• 60 minutes ($52)

Preferred Instructor

• Michelle Anderson | Banjo, Guitar, Bass, Ukulele
• Peter Vander Hout | Guitar, Piano, Voice, Woodwinds, Brass
• Barry G Player | Guitar, Bass, Voice
• Esteban Seunarine | Drums
• Terry Smith | Guitar, Bass, Mandolin, Ukulele, Piano

Student #2 *

First

Last

Instrument(s) *

Lesson Length *

• 30 minutes ($26)
• 45 minutes ($39)
• 60 minutes ($52)

Preferred Instructor

• Michelle Anderson | Banjo, Guitar, Bass, Ukulele
• Peter Vander Hout | Guitar, Piano, Voice, Woodwinds, Brass
• Barry G Player | Guitar, Bass, Voice
• Terry Smith | Guitar, Bass, Mandolin, Ukulele, Piano

Student #3 *

First

Last

Instrument(s) *

Lesson Length *

• 30 minutes ($26)
• 45 minutes ($39)
• 60 minutes ($52)

Preferred Instructor

• Michelle Anderson | Banjo, Guitar, Bass, Ukulele
• Peter Vander Hout | Guitar, Piano, Voice, Woodwinds, Brass
• Barry G Player | Guitar, Bass, Voice
• Terry Smith | Guitar, Bass, Mandolin, Ukulele, Piano

Student #4 *

First

Last

Instrument(s) *

Lesson Length *

• 30 minutes ($26)
• 45 minutes ($39)
• 60 minutes ($52)

Preferred Instructor

• Michelle Anderson | Banjo, Guitar, Bass, Ukulele
• Peter Vander Hout | Guitar, Piano, Voice, Woodwinds, Brass
• Barry G Player | Guitar, Bass, Voice
• Terry Smith | Guitar, Bass, Mandolin, Ukulele, Piano

Preferred Lesson Day & Time *

Alternative Lesson Day & Time

Please list alternative day(s) and time(s) that will work for you if your preferred lesson time is not available.

Questions or other requests?

Submit