Please register each child separately. Student InfoStudent Name* First Last Birth Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Age (As of September 1, 2020)* Parent Contact InfoParent/Guardian Name* First Last Mailing Address* Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Parent Phone*Parent Email* What is your preferred method of contact by the teacher/college?*Choose OnePhone CallTextEmailDoesn't matterStudent's Music BackgroundHow many years of piano lessons has the student taken?* What level of piano does the student have? (ie. Grade 3 RCM; Level 2A Faber)* What other musical experience does your child have? (ie. other instruments, choir in school, etc.) Would you like your child to take an exam in June?* Yes No Not Sure Does the student have any physical or learning issues that may affect how they are taught? If so, please explain. SchedulingHow long of a lesson will your child take?*Choose One30 min45 min1 hourPlease check all times that will work for lessons:* Select All Monday - 2:00 p.m. Monday - 3:00 p.m. Monday - 4:00 p.m. Monday - 5:00 p.m. Monday - 6:00 p.m. Tuesday - 3:00 p.m. Tuesday - 4:00 p.m. Tuesday - 5:00 p.m. Tuesday - 6:00 p.m. Tuesday - 7:00 p.m. Tuesday - 8:00 p.m. Wednesday - 3:00 p.m. Wednesday - 4:00 p.m. Wednesday - 5:00 p.m. Wednesday - 6:00 p.m. Wednesday - 7:00 p.m. Wednesday - 8:00 p.m. Thursdays - 4:00 p.m. Thursdays - 5:00 p.m. Thursdays - 6:00 p.m. Thursdays - 7:00 p.m. Thursdays - 8:00 p.m. Fridays - 4:00 p.m. Fridays - 5:00 p.m. Fridays - 6:00 p.m.