Alan Fraser Institute Questionnaire
You are registering for the following Institute: *
AMERICA
Oxford OH
Concord NH
ONLINE
Online Study Group
EUROPE
Berlin
Munich
Leusden
Ahun
Geneva
Hamm
Paris
Belgrade
... for the following number of days: *
all
1
2
3
4
5
6
7
8
For the
Pianimals Study Group,
which weeks will you attend?
(example: 1, 2, 5, 7, 8).
For the
Pianimals Study Group,
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 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 *
0-5
5-10
10-20
20-30
30-40
40-50
50-60
60-70
70-80
80-90
over 90
Email: *
Website:
Street Address: *
Cell phone: *