Private Music Instruction Registration Form
Student First Name *
Your answer
Student Last Name *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Parent/guardian name *
(please put N/A if you are an adult student)
Your answer
Contact telephone number *
Your answer
Contact email address *
Your answer
Street Address
Your answer
Mail Address *
(PO box and post code)
Your answer
Name of Current School (if applicable)
(please state if your child is home-schooled)
Your answer
Which instrument/s are you interested in? *
Required
Please state if your child is a beginner on the instrument he/she wishes to learn, or if they have any previous experience. *
Your answer
What lesson length are you interested in for individual private lessons? *
Required
How many individual private lessons per week are you interested in? *
Your answer
What payment option would you like to choose? *
Required
What date would you like to begin lessons? *
MM
/
DD
/
YYYY
Please state preferred days and times during the week for lessons. *
Your answer
Please state preferred location during the week for lessons (First Baptist Christian School students ONLY) *
Here at Spark! we pride ourselves on tailoring our curricula and materials to each individual student's needs. With this in mind, does the student have any Special Educational Needs or other needs that we should be aware of? *
Please briefly mention below (we will contact you if we require further information) or write N/A
Your answer
How did you hear about us? *
Required
I have read the policies and regulations of Spark! Music School and accept the terms of the agreement. *
(See "Policies and Regulations" page.)
Required
Electronic Signature of Student or Parent *
Your answer
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This form was created inside of Spark! School of Performing Arts.