Alan Fraser Institute Questionnaire

You are registering for the following Institute: *

... for the following number of days: *

For Pianimals Online,
which weeks will you attend?
(example: 1, 2, 5, 7, 8).

For Pianimals Online, in which weeks
will you participate actively?
(example: 2, 7, 8)

Your reasons for attending the Institute and your goals for the sessions?

What repertoire will you be bringing to the Institute? (auditors N/A)

Do you have or have you had a performance injury related to piano playing?
(If yes, please describe.)

Your degree of familiarity with the general ideas in Fraser’s books/DVD.

Your familiarity with the Feldenkrais Method.

What is your background musical education?

Your performing experience? Teaching experience?

Would you like any of your scheduled lessons to be a pure Feldenkrais Functional
Integration lesson instead of a piano or mixed piano/FI lesson?
(online institutes: N/A)

Do you have any scheduling restrictions? i.e. do you need your lesson to be at a
particular time of day, or will you not be able to attend at certain times?
(online institutes: N/A)

Any other comments, questions or concerns?

Prefix: [Mr, Mrs. Miss, Ms, Dr, Rev.]

Given name: *

Family name: *

Age *

Email: *

Website:

Street Address: *

Cell phone: *