Enrolment Form — Redemptorist centre of music

Name

First Name

Last Name

New OR Returning Student

New Student

Returning Student

Address

Date of Birth

Gender

Male

Female

Parent/Guardian's name (if under 18)

Mobile Phone

(###)

###

####

Landline

Email Address

Preferred way of Contact

(You may opt out of any of these means of contact at any time) (Tick as many as you wish)

Phone/Mobile

SMS

Post

Are there any medical conditions/learning needs that we should be aware of?

Please provide information of the instrument/programme you are applying for.

Please provide details of previous musical experience (if any).

How did you hear about the Redemptorist Centre of Music?

Returning Students

Please provide your current days and times for: Individual lesson, Theory Grade and Ensemble. If you wish to make any changes to your times please comment below.

I have read and accept the terms and conditions

Link to Terms & Conditions are below this form (under the Submit button).

Click here for Terms & Conditions