APPLICATION FORM

Summer Course 12th - 19th August 2012

 

 

 

 

 

Select appropriate category:

Senior

Junior

Observer/Associate Teacher

Select type of course:

Full seven day course with accommodation
Full seven day course without accommodation
Short four day course with accommodation
Short four day course without accommodation

Observers only:

Number of days with accommodation

 

Number of days without accommodation

 

 

 

 

First Name:

Surname:

Year of birth:

Instrument:

 

Contact e-mail address:

Telephone:

Facsimile:

 

Home Address:
Line 1:

Line 2:

Line 3:

Line 4:

City:

Post (Zip) Code:

Country (select):

 

Term-time address (if applicable):
Line 1:

Line 2:

Line 3:

Line 4:

City:

Post (Zip) Code:

Country (select):

 

Names of colleges/schools attended:

Name of main teacher:

Additional information (grades/degrees/diplomas obtained
& participation in concerts/festivals/competitions):

Proposed repertoire (may be changed at any time):

Payment:

All cheques should be made payable to :

North London Piano School

Overseas students should pay by sterling cheques.

Bursaries/scholarships

Those seeking bursaries/scholarships will be asked
to send a tape of their recorded performance.
They are advised to apply as soon as possible


78 Warwick Ave., Edgware,
Middlesex HA8 8UJ
United Kingdom

Tel 44(0)20 8958 5206
44(0)20 83633858
Fax 44(0)20 8958 5206
e-mail: nlpsch@hotmail.com

 

 

 

 

 

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