Student Information Form

 

For printable version of this form - please click here

Student Information form

Date
Student Name*
Age
Experience Level
Preferred days





Preferred times
Instrument
Teacher choice
(if known)
Lesson day
(office use)
Lesson time
(office use)

 

Parent/Guardian*
Home Phone
Work Phone
Cell Phone
Email address *
Street address
City
Postal Code
Terms and Conditions
Payments must be made either by post-dated cheques for the term or balance of the term (Sept.-Dec.) (Jan.-June), or automatically each month by Visa or Mastercard.
We will attach an imprint to this form if you choose to pay by credit card. Payments by cash or debit card MUST be prepaid each month.
Lessons cancelled by the teacher will be made up at a mutually agreed upon time. If this cannot be done, a credit for the missed lesson will be given.
If the student cancels the lesson, the shop must receive at least 24 hours’ notice of the cancellation – call the shop and leave a message.
Courtenay - 250-334-4885; Port Alberni - 250-723-3057; Campbell River - 250-830-0633
In the case a make-up lesson will be given at a mutually agreed upon time or a credit given for the missed lesson.

Cancellation with less than 24 hours’ notice will result in the forfeiture of that lesson.

 
Terms & Conditions*
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