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Student Contact Evaluation Form
Assessment and Feedback for Improved Student Engagement
What is the best time to contact you?
Morning (9 am-12 pm)
Afternoon (12 pm-4 pm)
Evening (4 pm-8 pm)
Who are the lessons for?
Myself
Child
Both
Students Age
7-9 Years Old
10-12 Years Old
Teenager (13-17)
Adult (18+)
How long have you been playing guitar?
Never Played Before
0-6 Months
6-12 Months
1-3 Years
3-5 Years
5+ Years
Have you taken guitar lessons before?
Yes
No
I’ve taken lessons for another instrument (piano, voice, etc.)
Do you have a guitar? (Select all that apply)
Yes
No
Not Yet, But I’ll be purchasing one soon
What are your long-term musical goals? (select all that apply)
Play for Friends and Family
Learn to Play Songs
Write My Own Songs
Play with other people
Perform at Open Mics
Play In A Band
Record
Professional Musician
Learn Guitar Playing Fundamentals
Be More Expressive in My Playing
Play Lead Guitar
Be Able to Improvise
Understand and apply Music Theory
Other
What are your short-term musical goals? (select all that apply)
Play for Friends and Family
Learn to Play Songs
Write My Own Songs
Play with other people
Perform at Open Mics
Play In A Band
Record
Professional Musician
Learn Guitar Playing Fundamentals
Be More Expressive in My Playing
Play Lead Guitar
Be Able to Improvise
Understand and apply Music Theory
Other
What are the biggest challenges or frustrations you are facing in your guitar playing right now? (select all that apply)
I’m brand new and need to start playing
I can’t play as fast as I would like to
I have difficulty changing chords smoothly
I can’t play through a song without making mistakes
I’m not sure what to practice to improve my playing
I’m not sure how to practice effectively
I’m not progressing as fast as I want to be
I’m not sure what my problems are
Other
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