Early Starters Music & Movement Enrolment
How did you hear about Advantage Music Academy?
*
Select
Facebook search
Facebook ad
Facebook Group
Flyer in another local business
Google search
Google ad
Google map search
Outdoor sign at Cottesloe Central
Poster in Cottesloe Central
Referral from a student
Referral from a teacher
Shopfront
Stall in Cottesloe Central
Stall somewhere else
Music Teachers Online website
Primary Contact Information
This section pertains to the person who is responsible for all aspects of the student's enrolment.
Full Name
*
Primary Contact Relationship to Student
*
Select
Mother;Father;Step-mother;Step-father;Grandmother;Grandfather;Nanny;Other;
Phone
*
Email
*
Postcode
*
Secondary Contact Person
This section pertains to an optional secondary contact person, such as another parent or a nanny who may bring the child to their lessons.
Full Name
Secondary Contact Relationship to Student
Select
Mother;Father;Step-mother;Step-father;Grandmother;Grandfather;Nanny;Other;
Phone
Email
Student Information
Last Name
*
First Name
*
Date of Birth
*
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Other relevant information
Enrolment Details
Class
*
Select
Tuesday 9:30am
Wednesday 9:30am
Thursday 9:30am
Friday 9:30am
SUBMIT