Lesson Request Form

Music Lessons Request



A valid credit card number must be kept on file.

Credit card auto pay : Cards are drafted on or about the 5th of each month.

Statements: Statements are sent out the 1st of the month. Statements are sent by email; there will be a $5.00 monthly charge for paper statements.Any student not paid in full on the 10th day of the month will have lessons suspended and may be dropped from the program. The student will be subject to a non-refundable re-registration fee of $20.
The $20 re-registration fee will be charged for lesson inactivity of longer than 30 days.

To expedite the scheduling process and to confirm your lessons we require advanced payment prior to your first lesson.

Autopay is required.


Thank you for contacting us!

Thank you for your lesson request. We look forward to responding your request as soon as possible.

Should you have a more immediate need, do call us at 336.274.4636.

Al Stephens,

Moore Music Company.