Your Full Name
Your Parents Name (Minors Only)
Your E-mail Address
Your Cell Phone #
Location Choice
Potential Singing Clients
Have you had singing lessons before?
What singing techniques have you studied, if any?
Do you sing professionally?
Do you want to sing professionally?
What type of songs do you like to sing?
Favorite shows or artists?
Are you a member of a union?
If so, which one?
Do you have an agent or a manager?
Do you have a record deal?
How quickly do you need to schedule something?
How would your prefer to be contacted,
by phone or by e-mail?
Were you referred for lessons by one of my current
students?  What is their name?
Did your flyer contain a promo CODE?  It might be a
number or a name.  Please enter it below.
Do you have any medical issues with your voice?
What is your MYSPACE address if you have one?
Please make sure your SPAM or JUNK mail filter is set to NOT block e-mail from adam@everythingadam.com to receive a
response with prices, locations, and schedules.
You understand Adam Roebuck Studios has a strict 48 hour cancellation policy, and you will be required to pay for any lessons, not
cancelled with at least 48 hours notice?
EverythingAdam.com
Only potential students over the age of 18 may fill out this form.  Anyone under 18 must have a parent or guardian fill it out for them.