Wells Music College Application Form

Personal Details of Applicant

First Name *

Surname *

Date of birth *

Is the applicant under the age of 18? *

Yes
No

Current school (if applicable)

Phone *

Email *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Principal Instrument Details

Name of instrument/voice *

Length of time studied (if at all)

Present teacher (if any)

Details of most recent examination passed (please give grade, mark and date)

Approximate standard at time of application

Other instruments (if any)

Second instrument/voice details

Please include the name of instrument/voice, how long you've studied and the most recent examination passed (please give grade, mark and date).

Third instrument/voice details

Please include the name of instrument/voice, how long you've studied and the most recent examination passed (please give grade, mark and date).

Fourth instrument/voice details

Please include the name of instrument/voice, how long you've studied and the most recent examination passed (please give grade, mark and date).

Application Details

For what instrument(s) and/or voice do you want lessons? *

Preferred length of lesson(s) *

30 minutes
45 minutes
60 minutes

Preferred / possible evenings *

Please tick all that apply

Music Education

Please give brief details of any ensembles, choirs, musicianship or theory classes that you have attended in or out of school.

Please list any music examinations (not instrumental) passed.

How did you hear about Wells Music College?

Parent/Guardian Details

Title *

(Mr, Mrs, etc)

First Name *

Surname *

Main address of applicant *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Preferred telephone number *

Contact email address *

Declaration

Multiple Choice *

As / On behalf of the student named, I apply for membership of Wells Music College. I have read the ‘terms and conditions’ as outlined in the prospectus and understand that a FULL term’s notice is required for withdrawal of a pupil from Wells Music College.

Signature *

Clear Signature

Name of Signatory *

Date *