Booking form - workshop
Workshop leader: Penelope Roskell

Venue: The Studio, 66 Queen Elizabeth’s Walk, Stoke Newington, London N16 5UQ
Email address *
Course title and date *
Name *
Your answer
Address and postcode *
Your answer
Telephone Number *
Your answer
How did you hear about the course? *
Your answer
Age *
What are your piano playing experience, qualifications or teaching qualifications? *
Your answer
Which aspects of piano technique would you most like to be discussed?
Your answer
Will you be bringing any specific pieces or passages that you find challenging? If so, please specify:
Your answer
Are you happy to be added to my mailing list for news and information on courses and concerts? *
Please sign (simply type your name in full) and date this form to signify your acceptance: *
Your answer
Thank you for applying for this course
Booking: Once your application has been acknowledged and availability confirmed, you will be asked to confirm your place with payment in full.

Refunds: Cancellation made at least four weeks before the start of the course will receive a 50% refund. There will be no refund due for cancellations made within 28 days of the beginning of the course.
A copy of your responses will be emailed to the address you provided.
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