BOOKING FORM
Instrument Lessons
Type:
PLAY IT AGAIN
Dates:
Sept. 2014 – Jul. 2015
Pupil Details
Surname:
First Name(s):
School Attended:
Home Address:
Post Code:
Date of birth:
Email:
Tel / Mobile:
1st choice
2nd choice
Instrument:
Instrument:
Instrument Hire Rates
Band A - £20 per term/
Band B - £25 per term/
Band C - £30 per term/
£5 per month
£6.25 per month
£7.50 per month
Clarinet
Alto Saxophone
Euphonium
Cornet
Baritone Horn
Tenor Saxophone
Flute
Bassoon
Guitar
Cello
Keyboard
Double Bass
Trombone
French Horn
Trumpet
Oboe
Viola
Tenor Horn
Violin
Tuba
Payment
I wish to pay by standing order and have completed and enclosed the SO form
I enclose a cheque for annual tuition and instrument hire (if required)
Cheques should be made payable to ‘Love Music Trust’ and be sent together with the completed
booking form to:
Mandi Cragg, The Love Music Trust, c/o Sandbach School, Crewe Road, Sandbach, CW11 3NS
Tel: 01270 758972
Print name (parent/carer/guardian):
Parent/carer/guardian signature:
Date: