Super Leads Academy of Music
342 Copper Creek Dr, Markham, ON L6B 1N8
superleadsacademy@gmail.com
416-825-7950
New Student Registration Form
Student Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
What class would you like to take?
*
Please Select
Guitar
Western Vocal
Piano
Carnatic Vocal
Saxophone
Were you referred by anyone if so who?
*
Starting Date:
-
Month
-
Day
Year
Date
Do you have any questions or concerns?
Signature:
Parent First and Last Name:
First Name
Last Name
Should be Empty: