Advanced London Piano Course - Booking Form
Workshop leader: Penelope Roskell

Venue: The Studio, 66 Queen Elizabeth’s Walk, Stoke Newington, London N16 5UQ
Email address *
Date of the course you are applying for *
Your answer
Name *
Your answer
Address & postcode *
Your answer
Telephone number/s *
Your answer
How did you hear about the course *
Your answer
What age are you *
Piano qualifications and experience: *
Your answer
Repertoire you would like to play during the course (time permitting):
Your answer
Other pieces you have been working on recently: *
Your answer
What stage are you at? *
Are you currently having lessons? *
Are you working towards any particular concert, exam or audition at the moment? *
Your answer
Do you have any particular problems/concerns that you would like to discuss during the course (time permitting)?
Your answer
Please sign (simply type your name in full) and date this form to signify your acceptance: *
Your answer
Are you happy to be added to the mailing list for news, events, courses and concerts? *
Thank you for signing up for a course
We will be in touch shortly to confirm your place with information on how to pay for the course. Half the fee is required asap, with the final half due two months before the course commences.

Booking: Once your application has been acknowledged and availability confirmed, you will be asked to confirm your place with payment in full.

Refunds: Payment in full is due in order to confirm the booking. 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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