MWVA Student Registration Form
Please complete the form fully for registration
Parent/Guardian Name
First Name
Last Name
Student Name
*
First Name
Last Name
Student Name (student 2 if applicable)
First Name
Last Name
Student Name (student 3 if applicable)
First Name
Last Name
Student Date of Birth
*
-
Day
-
Month
Year
Date Picker Icon
Student 2 Date of Birth
-
Day
-
Month
Year
Student 3 Date of Birth
-
Day
-
Month
Year
Address
*
Street Address
Street Address Line 2
Town
County
Eircode
Contact E-mail
*
For receipt of school notifications and invoices
Mobile Phone Number
*
Main Contact for lessons. Please enter a valid phone number
Alternative Phone Number
Other parent/guardian/grandparent/child minder Please enter a valid phone number.
Scheduled Lesson Day & Time (if known)
Instrument Choice
*
Singing
Violin
Fiddle
Guitar
Ukulele
Piano
Classical Flute
Traditional Flute
Harp
Recorder
Tin Whistle
Concertina
Theory
Singing Buddies Club
Social Media Policy
I give my permission to Mid-West Vocal Academy & Music School to use any images or video of me/my child on the Mid-West Vocal Academy & Music School social media sites - Facebook, Instagram & Twitter as well as the school website - www.midwestvocalacademy.com. I understand that these images will be placed on the relevant social media site for a maximum of 2 years.
Individual Images
Individual Videos
Group Images/Videos
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