Application Form for ABRSM Music Theory Course and Exam
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Which Music Theory Course are you booking?:
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Grade 5 - 20 week course for November 2019 exam - Friday 5.45 to 7.00
Grade 5 - 15 week course for November 2019 exam - Monday 5.45 to 7.00
Where would you like to take the exam?:
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Enfield
Crouch End
Ilford
Hertford
Name of candidate (as it will appear on certificate - including middle name):
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Date of birth:
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Postal address:
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Candidate’s gender:
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Does the Candidate have special needs?:
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If ‘Yes’ please give details below:
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Please give details of current instruments and grades taken:
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Contact email address:
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Contact phone number:
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Contact postal address (if different):
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Parent’s name (if applicable):
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