Student Information

Student Name *

Student

Date of Birth *

Allergies *

If Yes, Please explain.

Parent/Guardian Information (If Applicable)

Parent Guardian

Date of Birth

Contact Information

(Must be over 18 or parent/guardian of student)

Address *

Mobile *

Email *

Type Of Tuition - Please tick appropriate box *

1) Group Tuition: Cost $280 for 10-week Term. (At Lake Cathie Community Centre: minimum 5 students)
2) Private Tuition (Beginner): Cost $450 per 10-week Term.
3) Private Tuition (Intermediate/Advanced): Cost $900 for 10-week Term.
4) Dual Tuition (Beginner. Students must have the same level of experience): Cost $350 per 10-week Term.

Policy/Terms and Conditions:

By submitting this form, you are confirming that you have read, understood and agree to Affirmation School of Music's Terms and Conditions and Privacy Policy as stated at affirmationschoolofmusic.com.au

You also agree to Affirmation School of Music taking photos and videos of you or your child (if child is under 18) to be used on their website and facebook page for promotional purposes.

Student Enrolment Form

Student Information

Contact Information

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