International Piano Academy

International Piano Academy
Is the student a day student or a boarder?

Day studentBoarding student
Student's name*

First NameLast Name
Year group*
Student's date of birth*

DayMonthYear
Nationality*
House (if already at Rossall)
Name of parent or guardian*

First NameLast Name
Email address*

Confirmation Email
How did you hear about the Piano Academy?
By signing this form I agree to:
- Academy fees of £1600 per term being added to my bill
- Providing a full term's notice for withdrawal from the programme as per the Rossall School terms and conditions
Signature*
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