Lesson Booking Form Swan Music Academy

Lesson Booking Form Swan Music Academy
Customer Details:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityProvince

Postal code
Phone Number*
E-mail
example@example.com
Which instrument or class do you want to register:
ex. Piano, Guitar, Vocal or Theory
Please select the session time that you will be attending*
Please request a different time if you do not find a time slot that suits you.
Will you be willing to recommend us?

YesNoMaybe
Music Session

Please give reference of any two people whom you feel:

	Full Name	Address	Contact Number
1
2

Select your level and number of classes you are booking.

Beginner ClassThe student has never had any lessons before and has no prior knowledge of the instrument or subject he is enrolling.

200.00ZAR Quantity
Item subtotal:0.00ZAR

Intermediate ClassThe student has been playing and attending lessons for more than 3 years and or has completed a grade level 3 certificate.

325.00ZAR Quantity

Advanced ClassThe student has attended lessons in his or her instrument for more than 6 years and or has completed a grade level 6 certificate or equivalent.

475.00ZAR Quantity

Enter coupon

Total

0.00ZAR

Should be Empty: