APPLICATION

HIGH NOTES MUSIC PROGRAM

Application form
Full Name of applicant*

First Name Last Name
Current Age*
Street Address*
City, Province, Postal Code*
E-mail*
Phone Number: Best one to contact you*

Area Code Phone Number
Do you have a mental health conditions?

NoYesI think so
Referred by*
Name and title
Main reason for referral*
Choose all that apply to you:*

I already know how to play an instrumentI have never taken instrumental music instruction beforeI have a piano or keyboard that I can practise onI have a guitar that I can practise onI prefer to learn to play the pianoI prefer to learn to play guitarI know how to read musicI am more interested in classical musicI am more interested in current musicIf accepted, I would like to be considered for a subsidized instrumentIf accepted I am committed to attending my weekly lessons and will give at least 24 hours notice if unable to attend my lesson as scheduled.I understand that the registered charity HIGH NOTES AVANTE is paying for the lesson fees, material and rent and will still have to pay the teachers if I don't communicate my absence in advance. Therefore, they can discontinue the lessons if they find I am not being respectful
Are you able to travel to our program location at Yonge north of Major Mackenzie?

YesNo
If not, what is the nearest intersection to you?
What is your availability (for a 30 minute music lesson)?

I am flexible and will take whatever slot I getMondays 6-9:00 pmWednesdays 6-9:00 pm (afternoons/evening)Saturdays 10:00 am-1:00 pmSaturdays 1:00-4:00 pmOther possibilities:_____________________________________________I would prefer an online lesson
Please provide any additional information to support your application to the program:
Optional References

Could be anyone who can vouch that participating will benefit you.
Reference #1 Name, Phone, Email & Relationship to you
Reference #2 Name, Phone, Email & Relationship to you
Thank you for applying to High Notes Music Program

We are so excited to meet you and will be in touch as soon as possible.
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HIGH NOTES MUSIC PROGRAM

Optional References

Thank you for applying to High Notes Music Program