4 Giffords Lane, Staten Island NY 10308
Monday-Friday: 12:00 P.M. - 7:00 P.M. Saturday & Sunday 9:30 A.M. - 3:00 P.M.
718 569 0242

Parent Questionnaire

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718 569 0242
Monday-Friday: 12:00 P.M. - 7:00 P.M. Saturday & Sunday 9:30 A.M. - 3:00 P.M.

Our teachers at RockStars Rising realize we are all unique in our own way. To better get to know your child, we have come up with a questionnaire to get to know your child’s needs. Please take a moment to fill out the form so we can prepare our lessons and give your child the most incredible experience possible.


Type of music your child likes [Select all that apply]
 Rock Pop Heavy Metal Blues Country Jazz R&B Classical Reggae Hip Hop Rap

Instrument or instruments your child love to play?
 Vocals Guitar Bass Drums Piano

Would you prefer a male or female instructor?

Sensory issues
 Lights Sounds Touch

Is your child a
 Visual learner Auditory learner Read/Write learner Kinesthetic learner

Does your child learn best with
 Colors Numbers Letters

Social interaction
 Likes to be alone Likes to be with a group

Does your child adapt well to change? I.E. Changing music rooms or instructors?
 Yes No

Please Solve:2 + 4 =