Music Exam Support
National 5 / Higher / Advanced Higher Music
Name of Student
First Name
Last Name
Date of Birth
*
Pronouns
Please Select
He / Him
She / Her
They / Them
Other
Choice of Class
Please Select
National 5 (5 week block 8th, 22nd, 29th October 5th, 12th November)
Higher (5 week block September 3rd, 10th, 17th, 24th 1st October)
Advanced Higher 5 week block - 19th, 26th November 3rd, 10th, 17th December
Permission
*
Yes - I give permission for the student to be included in photos taken by the music academy during the class that may be used on social media and other publicity materials.
No - I do not give permission for the student to be included in photos taken by the music academy during the class that may be used on social media and other publicity materials.
Emergency Contact & Parent / Guardian Name
First Name
Last Name
Parent / Guardian Pronouns
Please Select
He / Him
She / Her
They / Them
Other
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal Code
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Terms & Condtions
Anything you’d like your tutor to know? Please share any relevant information, preferences, learning needs, or other notes that may help your tutor support you.
I agree
*
I understand that by signing up, I am committing to the full five-week period, and that classes are non-refundable if I am unable to attend.
I wish to receive emails promotional from Brick Lane Paisley
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