o n l i n e . e n r o l m e n t

Please complete a separate form for each child you wish to enrol.
Child's family name
Child's first names
Date of birth	Date Month  January February March April May June July August September October November December Year
Address	(number and street name)
	(suburb)
	(city)
E-mail address
Parent or Guardian	Mr Mrs Miss Ms Dr
Telephone	Home  Business
Instrument child wishes to learn	Flute Guitar Violin Oboe Clarinet Cello Trumpet Recorder
Do you want to hire an instrument?	Yes No
If violin or cello, size required	Full 3/4 1/2
Child's school next year
Child's class next year	Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8
Has your child  attended this music  centre before?	Yes No
Details of any previous music tuition	School/Teacher  Instrument  No. years
Names of brothers or sisters attending lessons or enrolling	1. Name  Instrument  2. Name  Instrument  3. Name  Instrument  4. Name  Instrument
Questions/Comments
Declaration	By clicking this circle, I, the parent or guardian, declare that the information I have supplied in this form is correct and understand that enrolment fees are refundable only if my child is not accepted for a class or if my family moves from the area before classes begin (ensure circle is clicked

You will receive an e-mail to confirm your enrolment within a few days after you have submitted this form.  For further information, please read the FAQ section or contact Georgina.