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How long have you been playing music?*
How long have you been playing music?*

What other musical instruments do you currently play? (Please check all that apply)

	Bass Guitar
	Piano/Keyboard
	Drums
	Vocals
	Other (please fill in the box below)

Who are your favorite bands/guitarists?*
Who are your favorite bands/guitarists?*

What styles of music do you want to learn? (Please check all that apply)*
What styles of music do you want to learn? (Please check all that apply)*

	Rock
	Classic Rock
	Metal
	Punk
	Alternative
	Progressive
	Pop
	Blues
	Other (please fill in the box below)

What are your long-term musical goals? (Please check all that apply)*
What are your long-term musical goals? (Please check all that apply)*

	For my own personal enjoyment
	I want to play like my favorite guitarist
	I want to jam with my friends
	I want to join/form a band
	I want to write/record my own songs
	I want to become a professional musician
	I want to learn different styles of music
	I want to teach guitar
	Other goal (please fill in the box below)

What three guitar-playing aspects are you struggling with right now?*
What three guitar-playing aspects are you struggling with right now?*

If I could help you improve on one of those challenges over the next 90 days, which would it be?*
If I could help you improve on one of those challenges over the next 90 days, which would it be?*

First Name*
First Name*

Last Name*
Last Name*

E-mail Address*
E-mail Address*

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Home Phone*

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Best time to call?*

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