Itinerant Music Lessons 2018
Please fill out a separate form for each instrument you want to learn.
Click the "submit" button at the bottom, then click "go back to the form" if you wish to sign up for another instrument.
Student's first name *
How you spell your name will be how it appears on the timetable and in the roll book.
Your answer
Student's Surname *
Your answer
Email address
Parent or caregiver's contact email
Your answer
Contact phone number *
This should be the preferred number to contact you on
Your answer
Other phone number
This could be mobile, home or work.
Your answer
Room *
Type the school name in "other" if you are NOT a Chisnallwood student. The room number helps us timetable to avoid clashes.
Year level in 2018
Please refer to the downloadable pdf for lesson costs or scroll down a bit
Group or individual preference *
Please indicate if you have a strong preference for learning in a group or having individual lessons
instrument hire
Please indicate if you would like to hire an instrument
Guitar/piano/keyboard only:
If you have a preference for a particular teacher please state here (otherwise leave blank):
Please note that by completing this form you are acknowledging the following:
• Pupils need to have an instrument (see Mrs. Bell or instrument teacher for help).
• Pupils must attend lessons on time with their music and instrument
• Pupils are required to practice between lessons (the amount will be set by the teacher)
• There may be some costs for purchasing music books. (Drumsticks, reeds, strings will need to be purchased)
• If unable to attend a lesson for any reason please let your teacher know by message or phone. You will be marked as present, excused or absent.
• To be excused is excusable but to be marked absent may incur the cost of the missed lesson.
• Pupils who wish to discontinue at the end of a term must let the music teacher know. If a student just stops showing up they will be liable to pay for missed lessons
• Pupils may be asked to stop learning if they have unpaid fees.
• Pupils must take good care of their instrument. There is a special storage room in the performing arts block for safe keeping.
• Pupils need to politely excuse themselves from class and need to be responsible for catching up any missed classroom work.
• The expectation is that lessons will continue for the whole year
Clicking "yes" indicates the parent or caregiver is giving permission and support for the student to learn and agrees with the responsibilities outlined above.
Parent/caregiver's name *
Your answer
Lesson Costs
Lesson cost - amount *
I understand the full cost of lessons for my chosen instrument is:
Your answer
Lesson payment *
I have read the cost of lessons and...
Commitment *
Clicking "yes" indicates the student agrees to attend lessons and practice between lessons.
Previous experience *
Please comment on whether you are a beginner or have experience. If you have experience please indicate how long you have learnt and/or the grade you have you have reached. Also any relevant performance groups you have been part of.
Your answer
Previous music teacher(s)
Your answer
Availablity for lesson times
Please indicate if you have times of the week you CANNOT have a lesson
Your answer
Any other comments
Your answer
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