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Summer History Class with Justin Lim
THANK YOU for your interest in exploring music history with me this summer at Jean Lyons School of Music. Please complete this form so that I have your information. If you have any other questions, you may e-mail Mr. Lim directly at theoryman@shaw.ca or use the additional box at the bottom. I will send you an e-mail to confirm receipt within 1-2 days.

IMPORTANT: Register for the new exam titles (Level 9 History; Level 10 History; ARCT History). I will consider your registration complete and confirmed once I see your name on my official RCM teacher's list. Therefore, you must input my teacher number (37574) on your RCM application. If you have already submitted your RCM application without my number, please contact RCM with the correction. Deadline for summer applications is June 1, 2018 at www.rcmusic.com.

LEVEL 9 HISTORY
M–Th, 10:00 am – 12:00 pm
Mon. July 9 – Tue. Aug. 7, 2018
17 classes: $695, plus textbooks and materials

LEVEL 10 HISTORY
M–Th, 1:00 pm – 3:00 pm
Mon. July 9 – Tue. Aug. 7, 2018
17 classes: $695, plus textbooks and materials

ARCT HISTORY
M–Th, 3:00 – 5:00 pm
Mon. July 9 – Tue. Aug. 7, 2018
17 classes: $695, plus textbooks and materials

Student's Full Name *
The name registered with RCM. LAST NAME, FIRST NAME: e.g. Smith, John
Your answer
Student's Common Name
What should I call you? e.g. Johnny
Your answer
Student's gender *
Male or Female?
RCME Number
Your answer
Which RCM History class do you want to take this summer? *
Parent or Guardian's name *
Your answer
Parent or Guardian's phone number *
e.g. xxx-xxx-xxxx
Your answer
Home Address *
Your answer
Parent or Guardian's e-mail address *
E-mail is the best way to communicate with me until the course begins
Your answer
Student's e-mail address *
Once the course begins, I will send regular class instructions by e-mail, so this should be an address that the student regularly checks
Your answer
Student's date of birth *
e.g. January 1, 2003
Your answer
Student's school & grade in 2017-2018 *
Current grade, e.g. Crofton House, 8
Your answer
Student's instrument(s) and level (as of June 2018) *
e.g. Piano 9, Violin 7
Your answer
Name of student's instrumental teacher(s) *
Your answer
Student's highest level of theory completed (as of May 2018) *
What other exams/camps/commitments will the student be working on this July? *
e.g. Grade 10 Piano exam; tennis camp from July 22-26
Your answer
How did you hear about Justin's history classes? *
e.g. name of friend, name of teacher, took Justin's class before, website, flyer, etc.
Your answer
Do you have some questions or concerns?
Your answer
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