Change of Enrolment: Discontinue

Change of Enrolment: Discontinue
Student name

First NameLast Name
Parent phone number
Please enter a valid phone number.
Instrument being discontinued
I wish to withdraw my child/myself from lessons as detailed above. I understand that withdrawals can only be made by the end of week 3 of each term, or at the end of term. If I wish to withdraw after week 3, I will be liable for the total fees for the term.

Submission of this form is equivalent to my signature.
Should be Empty: