AliJay Music Enrolment Form

Returning student - no details changed. Please fill out student name, check terms & conditions and payment section.

Returning student - details changed. Please enter new details, student name, check terms & conditions and payment section

PARENT/CAREGIVER (OR ADULT STUDENT) CONTACT DETAILS

First Name

Last Name

Phone

Address

If there is another adult who will be responsible for bringing to lessons or needing correspondence, please add their details here.

STUDENT DETAILS

Student Names

Student DOB

I have read and understood the above policy and agree to comply with the conditions as presented.

Select ONE of the following:

I will pay the full term payment by week 1

I will pay the 1st instalment of 50% by week 1 and the 2nd instalment by week 4

Form of Payment: (select ONE)

Cash

Online Deposit