E-Interview

Put a Passion in Every Child's Heart

Please complete the exit interview form and click on submit

Your Name: *

Student Name: *

Your Email: *

Progress: *
I am happy about my child's progress
I am have been concerned about my child's progress

Practicing: *
Lack of practicing
Does not practice well
No practice problems

Prior Communication: *
I have expressed my concerns to my child's teacher
I have never expressed my concerns to my child's teacher

Details about your concern: *

Schedule: *
Schedule does not work
No problem with schedule
Too many scheduling changes

I want to: *
Setup a meeting with the director
Change my child's teacher within the school
Others

My child is planning to: *
Stop playing the instrument completely
Change to a different Instrument
Have found a new teacher else where
Want to seek other alternatives at Opus119

Name of the new teacher or school: *

Billing: *
Charge the balance to my credit card on file
Send me a final bill
I will come in to finalize any payments that requires my attention

I fully understand the Opus119 withdraw policy *

I agree to pay any balance I have within 14 days of this notice: *

Please verify all information is correct: *