Performing Arts Application Form
Please contact Mr Malcolm Elvery with questions: 07 3353 1266 or email instrumental.music@northside.qld.edu.au

Visit our website for program details: https://www.northside.qld.edu.au/co-curricular/performing-arts

Please note the Terms and Conditions before completing this application form: https://s3-ap-southeast-2.amazonaws.com/digistorm-websites/ncc-au-qld-148-website/content/PDFs/Performing-Arts/Performing-Arts-Terms-and-Conditions.pdf?mtime=20171117121709

All Questions marked with a * need to be completed for the form to submit. An automatic confirmation email will then be sent to the email address you provided in Question 1. If you do not receive this email, your enrollment has not submitted.

Email address *
Application Date *
MM
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DD
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YYYY
Student's Family Name *
Your answer
Student's Given Name *
Your answer
Student's Date of Birth
MM
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DD
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YYYY
Student's Class *
Your answer
Student's Address (The contact details you give below will be used for communication between the Instrumental teacher and parents, including billing. Please give the details that will be the most reliable for these purposes.) *
Your answer
Mobile Phone *
Your answer
Work Phone
Your answer
Home Phone *
Your answer
Parent's Names *
Your answer
What instrument/subject do you wish to enrol for: *
Your answer
Has the student been enrolled on this instrument previously for private lessons at Northside? *
If no, please give details of student's musical experience (if any)
Your answer
Continuing students please give name of current teacher:
Your answer
Type of lessons requested *
Required
Preferred lessons time: *
Required
Comments/questions:
Your answer
Does this child have any medical conditions that the teacher should be aware of?
Your answer
Does this child have any learning difficulties that could impact their progress? (This will allow their teacher to adapt their teaching strategy, therefore improving outcomes for the student)
Your answer
Signed by: *
Select one
Required
Payment ($25 Enrolment Fee). The fee is only payable once per child per year, regardless of the number of instruments they learn. No more than 3 fees are payable per family. Enrolments cannot be accepted without this fee: *
Required
SABO or EFT receipt number (If enrolling a child for a second instrument, enter "2nd instrument for this student") *
Your answer
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. *
Required
A copy of your responses will be emailed to the address you provided.
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