Formulaire de Contact/Information Sheet

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🇫🇷Chers parents, chers élèves

Pour cette année scolaire 2025/2026 .Nous vous prions de bien vouloir remplir le questionnaire qui suit.

Merci de nous répondre pour les champs mentionnés par une étoile *

🇬🇧Dear Parents and Students,
For the 2025/2026 school year, please kindly fill out the following questionnaire.
Thank you for responding to the fields marked with an asterisk *.

Email *

👤- Your FIRST NAME & LAST NAME(S) *

📞- Your PHONE NUMBER (preferably usable with WhatsApp) *

Exemple : +971 5X XXX XXXX

📍- Your PLACE of Residence. (Google Map link, neighborhood name, street/villa/apartment number) *

✒️ INSCRIPTION/REGISTRATION

Veuillez indiquer le ou les noms des personnes qui suivront les cours.

Please indicate the name(s) of the person(s) who will be attending the classes.

Choisissez la langue du cours / Choose the language for the class.
*

🇫🇷FRENCH

🇬🇧ENGLISH

ENGLISH or FRENCH 🇬🇧🇫🇷

Required

👤 Student 1 > LAST NAME & FIRST NAME *

>Age *

👤 Student 2 > LAST NAME & FIRST NAME

> Age

🎶Cours de groupe souhaités/Group Classes

CHOIR Pop/Modern Songs - Adults (Tuesday 8pm-10pm) @Al Quoz - 1800 AED/Term

BAND ADULTES to be determined according number of participants

Clear selection

🎶Cours individuels souhaités /Individual Classes

Piano Lessons (6 years and older)

Singing Lessons (8 years and older)

Cello /Violon

Recorder and Flute Lessons (6 years and older)

Guitar/Ukulele Lessons (7 years and older)

Electric Guitar/Bass Lessons (8 years and older)

Saxophone Lessons (8 years and older)

Drum/Percussion Lessons (6 years and older)

Darbbuka Lessons

Harp Lessons ( 7 years and older)

Other:

⏱️Durée du cours souhaité/ Preferred Class Duration *

30-minute class (beginner children)

45-minute class (children/teens

60-minute class (adults/advanced students)

Option: 2 times per week

Priority request (Premium package )

Other:

Required

📆 Jours possible/ Scheduling Preferences

Merci d’indiquer vos jours et horaires souhaités, ainsi que l’heure de début la plus tôt et l’heure de fin la plus tard possible.

Please indicate your preferred days and times, as well as the earliest start time and the latest end time.

ℹ️ Please make sure to review the prices and general terms and conditions.

🇫🇷Je reconnais avoir pris connaissance des conditions générales ( une version pdf vous sera envoyé lors de notre premiere prise de contact)

🇬🇧I acknowledge having read the general terms and conditions (a PDF version will be sent to you during our first contact).
*

Lu et approuve / Read and approved

Required

🇫🇷Merci de votre solicitation et votre confiance !

Vous allez être recontacte prochainement.

🇬🇧Thank you for your inquiry and trust!
You will be contacted shortly.

A bientôt chez vous / See you soon 😄

Culture Emulsion🎶🎵

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