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* 1. Do you know anything about the following?  Please check all that apply.

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* 2. If so, what is your experience with it?

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* 3. What types of lessons would you most be interested in?  Please check all that apply.

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* 4. Which days of the week would you be available for lessons? Please check all that apply.

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* 5. Which times of day would you be available?  Please check all that apply.

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* 6. What do you hope to accomplish by taking classes?

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* 7. Which types of lessons would you be interested in?

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* 8. Name

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* 9. Email address

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* 10. Cell phone

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