Naomi Cooper Music Studio Enrolment

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Student's Name* This field is required.
First Name
Last Name
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Student's pronounseg. he/him/she/her/they/them
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Are you completing this form for a student under 18 years of age?* This field is required.
YESNO
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Are you a current student or new student?* This field is required.
Current student updating my details
New student enrolling for the first time
Returning student (been away for a term or longer)
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What type of lesson are you enrolling in* This field is required.
Guitar
Singing
Guitar + singing
Musicianship
Choir director mentoring
Other
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What is your preferred lesson length?* This field is required.
60 minutes ($1300 per term)
30 minutes ($650 per term)
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Parent/Guardian's Name* This field is required.
First Name
Last Name
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Parent/Guardian's Email Address* This field is required.
example@example.com
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Parent/Guardian's Phone Number* This field is required.
Please enter a valid phone number.
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Email Address* This field is required.
example@example.com
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Phone Number* This field is required.
Please enter a valid phone number.
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Anything I should know (optional)I am committed to providing high quality music education to students of all levels and abilities. I have experience working with neurodivergent students and students with disabilities. It is best for me to be aware of any support needs or strategies that work best in order to optimise the learning experience of each student. You might also like to share some musical background information other things that excite and inspire you to help me plan for our first lesson.
Huge
Large
Normal
Small
Ok
Ok
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Missed lessons* This field is required.When you enrol for music tuition, I am reserving capacity in my schedule specifically for you and I will not give this capacity away to anyone else. This means that missed lessons cannot be rescheduled but you can rest assured that your money will still be working for you because my carefully structured approach to teaching ensures you will continue to develop your skills between lessons. In addition to your lesson time, the capacity I set aside for you includes planning, preparation, professional development, administration, and communication. The annual tuition amount allows for occasional teacher absences due to unforeseen circumstances such as illness.
I acknowledge that I have been informed of this missed lesson policy
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Invoice Payments* This field is required.An invoice for the school term will be sent prior to the start of the term and payment is due before the first lesson of term. If you need longer than the due date or to set up a payment plan, please contact me before the invoice due date (otherwise a late payment fee may be charged and lessons may be discontinued until the invoice is paid). Payment can be made by direct deposit or credit card. Term rates are subject to change at the beginning of each financial year but will not change more than once a year.
I acknowledge that I have been informed of this invoice payment policy
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Discontinuing lessons* This field is required.Enrolment in music tuition is on an annual basis, with four equal payments each term. Should you wish to discontinue lessons during the course of the annual program, one term's notice is required. This allows me to make the lesson time available to another student and to wrap up lessons in a logical way.
I acknowledge that I have been informed of this lesson discontinuation policy
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Media Release* This field is required.Do you give permission for photos and/or videos to be taken during lessons or performances with Naomi Cooper's Music Studio and for these to be used for marketing or on our social media (e.g. websites, Facebook and Instagram)?
YESNO
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How did you hear about my studio?* This field is required.
Word of mouth
Google search
Social media
Referred by another teacher
Saw an advertisement
Other
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Any questions
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Signature
Clear
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