Inquiry Form
Thank you for your interest in our products or services. Please complete the form and send it to us. We will get back to you as soon as possible.
Note: Marked with
*
are required.
Section 1
1.1
Please check the information package you would like to receive:
Product Information
Purchase Information
Company Information
Other
Product Release Notification
1.2
Additional requests or comments:
1.3
How would you like to receive this information?
By E-mail
By Regular Mail
By Fax
Call me
Section 2
2.1
Please provide us with your contact information:
Name:
*
Title:
Company:
Address:
*
City:
*
State/Province:
Country:
*
Post / Zip Code:
Phone:
Fax:
E-mail:
*
Web Site:
Section 3
(optional)
3.1
Contacting on behalf of a third party:
Association/Agency
Government Dept.
School
School Board
Parent
Teacher
Student
3.2
Do you use a guided curriculum?
Yes
No
3.3
Do you use any music based courseware?
Yes
No
3.4
Do you use a music lab?
Yes
No
3.5
Do you have access to a computer(s)?
Yes
No
3.6
If yes, where do you have access to a computer(s)?
Home
School
Office
Other
3.7
Do you have access to an electronic keyboard(s)?
Yes
No
3.8
If yes, what brand of electronic keyboard(s)?
Technics
Casio
Yamaha
Other
Roland
3.9
If are a teacher, what grade levels do you instruct?
Elementary
University or College
Middle School
Other
High School
3.10
How many students do you instruct?
0 to 30
31 to 60
61 to 100
100 Plus
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