HIGH NOTES MUSIC PROGRAM
Full Name of applicant
City, Province, Postal Code
Phone Number: Best one to contact you
Do you have a mental health conditions?
I think so
Name and title
Main reason for referral
Choose all that apply to you:
I already know how to play an instrument
I have never taken instrumental music instruction before
I have a piano or keyboard that I can practise on
I have a guitar that I can practise on
I prefer to learn to play the piano
I prefer to learn to play guitar
I know how to read music
I am more interested in classical music
I am more interested in current music
If accepted, I would like to be considered for a subsidized instrument
If 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?
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 get
Mondays 6-9:00 pm
Wednesdays 6-9:00 pm (afternoons/evening)
Saturdays 10:00 am-1:00 pm
Saturdays 1:00-4:00 pm
I would prefer an online lesson
Please provide any additional information to support your application to the program:
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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