SLIGO ACADEMY OF MUSIC
7 Lower The Mall,
Sligo
087-6847792
Charity No. CHY 15547
ENROLMENT FORM
Student Name (Capitals) ____________________________
Parent/Guardian Name
_____________________________
D.O.B.________________
Daytime Tel No. ______________
Address of Fee Payer ________________________________________________________________
Evening Tel. No. __________________Mobile No. __________________Email __________________
Subjects requested – Please circle:
Violin
Flute
Trumpet
Piano
Junior Cert
Viola
Oboe
French horn
Singing
Leaving Cert 5th or 6th yr
Cello
Clarinet
Trombone
Vocal Ensemble
Sinfonietta
Double Bass
Saxophone
Guitar
Chamber Music
Junior Orchestra
Recorder
Bassoon
Classical Guitar
Theory
Jazz Orchestra
Musical Explorers 1: age 3-4
Musical Explorers 2: age 5-6
Jazz Improvisation
Preferred Class Times: Please give as wide a choice as possible. Every effort will be made to
accommodate preference – however, no guarantee can be made.
Day
_______________________________________
Time/s____________________________
Teacher ______________________________
Family circumstances/Learning difficulties ________________________________________
Please note that any information disclosed here will be treated in strict confidence. It is important that the teacher is
made aware of any circumstances which could affect your child’s behaviour in class or ability to learn
I have read and agree to adhere to the Sligo Academy of Music Regulations.
Signed Parent/Guardian _____________________________
Date _______________________
Please note that the Sligo Academy of Music is not responsible for your child outside of lesson time.