Northern Violin Studio - Enrolment Form
All information on this form is secure and remains confidential.
Parent/Carer Name
*
First Name
Last Name
Full Name of Student
*
First Name
Last Name
Preferred name of Student
*
Parent/Carer Email
*
example@example.com
Parent/Carer Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Carer Alternative Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Student's Year of Birth
*
-
Month
-
Day
Year
Date
Student's age in years
*
Name of Student's School (students may opt to be grouped with students from the same school)
*
Student Year level in 2024 (i.e. Year 4/Grade 4)
*
Lessons will be allocated after school times on Wednesdays. It may not always be possible to have your preferred time. Which type of lesson would you like to enrol for
*
Group lesson, 30 minutes (up to 4 in a group) - $37.50 per student
Group lesson, 45 minutes (up to 4 in a group) - $52.50 per student
Group lesson, 60 minutes (up to 4 in a group) - $67.50 per student
Individual lesson, 30 minutes - $62.70 per lesson
Individual lesson, 45 minutes - $82.50 per lesson
Individual lesson, 60 minutes - $99.00 per lesson
Does your child wish to be paired with a friend/s also enrolling for lessons? (Maximum 4 per lesson). Please provide names.
What is the musical background of your child. More details can be entered below.
*
Has never played an instrument before
Has played violin before
Plays another instrument
Learns music in school
Please provide details (How many years has your student been learning their instrument/other instrument name and how long they have been learning, etc.)
It is understood that all students are individuals and that everyone learns in different ways and at different times. Is there anything that you would like to share that would help Karen understand how to best work with your child? All information shared will be treated with confidentiality.
Does your child have any relevant medical needs or conditions? (Allergies, seizures, diabetes, etc)
*
Yes
No
If YES, please provide relevant information including medical action plan. You may choose to email seperate documentation to northernviolinstudio@gmail.com
Is there anything else you would like Karen to know about your child?
I have read the Northern Violin Studio Policy brochure and understand my obligations (please tick)
*
YES, I have read the studio policy and understand my obligations
I understand that all fees must be paid in advance
*
YES, fees will be paid before the commencement of lessons each term
Parent signature
*
Submit
Submit
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