Music Lesson Enrolment Form
Please complete the following form to enrol in music lessons at C-MAT.
STUDENT DETAILS
Student First Name *
Your answer
Student Last Name *
Your answer
Student Email (optional)
Your answer
Student Phone (optional)
Your answer
School Attending (optional)
Your answer
Student Date of Birth
MM
/
DD
/
YYYY
PARENT ONE DETAILS
Parent One Title (Mr, Mrs etc) *
Parent One First Name *
Your answer
Parent One Last Name *
Your answer
Parent One Mobile Number *
Your answer
Parent One Home Phone Number (optional)
Your answer
Parent One Email Address *
Your answer
Parent One Address *
Your answer
PARENT TWO DETAILS (optional)
Parent Two Title (Mr, Mrs etc)
Parent Two First Name (optional)
Your answer
Parent Two Last Name (optional)
Your answer
Parent Two Mobile Number (optional)
Your answer
Parent Two Home Phone Number (optional)
Your answer
Parent Two Email Address (optional)
Your answer
Parent Two Address (optional)
Your answer
REQUESTS
Course Interested In *
Required
Lesson Location
Lesson Day *
Lesson Time *
Time
:
Special Requests / Comments
Your answer
Terms and Conditions
By submitting this form - you agree to abide by the terms and conditions for music lessons as outlined on the www.c-mat.com.au/fees-school-policy/ website.
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