LEE ELLIE MUSIC SCHOOL
PERSONAL DATA
NAME (SURNAME FIRST):__________________________________________________
AGE: ____________________________________________________________________
OCCUPATION:
____________________________________________________________
PHONE NUMBER:
____________________ E-MAIL: _____________________________
HOME ADDRESS:
_________________________________________________________
COURSE/ TRAINING DATA
INSTRUMENT(S) OR COURSE OF INTEREST?
___________________________________________
EXPERIENCE: BEGINNER
( ) INTERMEDIATE ( ) ADVANCED (
)
HAVE YOU TAKEN MUSIC LESSONS
BEFORE? YES ( ) NO ( )
DO YOU HAVE A KNOWLEDGE OF MUSIC THEORY? YES ( ) NO ( )
PATH OF PREFERENCE? CLASSICAL ( ) CONTEMPORARY ( )
CAN YOU SIGHTSING MUSIC/
SIGHTPLAY MUSIC? YES ( ) NO ( )
WOULD YOU LIKE TO TAKE HOME ( ) OR CLASS ( ) LESSONS?
FEES PAID? YES ( ) NO ( ) WORKSHOP ( )
DECLARATION
I hereby declare that the information I have given
about me are true, to the best of my knowledge.
DATE OF REGISTRATION: ____________ SIGNATURE:
________________
FORM: N2000 ONLY. PAY TO FIRST BANK - 2018099704 - LEE VOCAL STUDIOS. MONTHLY PAYMENTS SHOULD BE PAID INTO THIS ACCOUNT BEFORE TEACHING COMMENCES. CASH SHOULD NOT BE HANDED TO ANY TEACHER AS
CASH PAYMENTS ARE NOT WELCOME. PLEASE
NOTE: ALL FEES ARE NONREFUNDABLE AND CLASSES MISSED WILL NOT BE REPEATED. FEES ARE TO BE PAID AFTER THE FOURTH LESSON TO AVOID A BREAK IN THE FLOW OF LESSONS. ATTACH A PASSPORT PHOTO TO THIS FORM. PRINT, FILL, SCAN & SEND FORM TO heroscake.2012@gmail.com.
