JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
ICC Music Class Registration 2020 Autumn Online Term
Check Website for course dates.
Due to the ongoing impact of Covid-19, this term will be based online. Access to the tutors' online accounts will only be granted on receipt of the course fee.
Privacy: Your data will not be shared with any external agencies and will be seen only by staff and tutors of the Irish Cultural Centre Hammersmith.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name:
*
Your answer
What class would you like to register for?
*
Bodhran
How to accompany Irish Music (Backers Club)
Children's Backers Class
Tin Whistle
Flute
Fiddle
Singing
Address:
Your answer
Date of Birth (dd/mm/yyyy):
Your answer
Telephone Number:
*
Your answer
Occupation:
Your answer
Is this your first time participating in the Irish Cultural Centre Education Programme?
Yes
No
Clear selection
If you answered 'No' to the last question please tell us which class:
Your answer
Are you Irish Born?*
*
*Not a requirement
Yes
No
Are you of Irish descent?*
*
*Not a requirement
Yes
No
Don't Know
How did you hear about the centre?
Your answer
Do you accept the terms and conditions as stated below:
*
Yes
No
I confirm, by signing below, that I have read and accepted the terms and conditions of subscription and participation in the ICCH Ltd Education Programme* and all information given is up to date and correct.
*
Please sign by typing name and date.
Your answer
The class fee for this term is stated on the relevant class page on our website. Please use the payment button on the class page and select 'pay by credit or debit card' when prompted.
Alternatively, please email
william@irishculturalcentre.co.uk
who can supply you with the means to pay via online bank transfer. Thank you.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Irish Cultural Centre Hammersmith.
Report Abuse
Forms
