Fonthill Music Academy - Fonthill, Ontario

Registration Form

Program/Lesson

Student

First Name

Last Name

Address

City

Postal Code

Home Phone

Work Phone

Ext.

Cell Phone

Birthdate (mm/dd/yyyy)

Is there something specific you would like us to know (ie. allergies, behaviors, etc.)?

How did you hear about our studio?

Emergency Contact

First Name

Last Name

Phone Number

Program & Musical History

Are you a beginner?

Yes

Do you own your own instrument?

Yes

Have you had previous instruction?

Yes

Number of years training with instrument

Previous musical exposure (please list other instruments, or music lessons)

Parent/Guardian(s)

First Name

Last Name

Same as student

Address

City

Postal Code

Home Phone

Work Phone

Ext.

Cell Phone

First Name

Last Name

Same as student

Address

City

Postal Code

Home Phone

Work Phone

Ext.

Cell Phone

Information about lesson dates/times, payment plans and additional information will be discussed once registration has been received to us. Please expect a call within the next few days from us. Must attend classes on a regular basis and follow the program guidelines. Absence does not excuse payment.

905-892-4141

Course Registration

Registration Form

Student

Emergency Contact

Program & Musical History

Parent/Guardian(s)