Music for You 2011 - Registration Form
Name
Title
Address first line
Address second line
Address third line
Postcode
Daytime Telephone No:
Evening Telephone No:
Mobile No:
Primary/Doubling Instrument:
Emergency Contact:
Instrument Standard:
Date of Birth
E-mail
Section Principal
No
Yes
Course Selection (Tick all that apply)
Chamber Music Course
Intermediate & Beginners Course
Conductors Course
Orchestral Course
Beginner Strings
Summer Jazz Course
Summer Jazz Vocal Course
Easter Jazz Workshop
Accommodation Preferences
Residential (Full Board & En Suite)
Budget (No Food, Single Room)
Non-Residential (No Food)
Extra Night Accommodation (B & B)
No
Yes
Non Residential Meals Supplement
No
Yes
Unaccompanied Minor Under 18
No
Yes
Disabled
No
Yes
Medical Information
Dietary requirements please specify
Total Fees Due
Payment Method
Cheque
Paypal
Please fill in form and click 'SEND' button.