Information about Christian Institute of Contemporary Music (CICOM) Enquiry Form

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Information about Christian Institute of Contemporary Music (CICOM) Enquiry Form - Next Enrolment Sept 2019

This form registers you for information about CICOM, its courses, and other programmes only. These courses are run at CICOM Institute of Contemporary Music, The Rayners, 23 Village Way East, Harrow, HA2 7LX. Saturday courses delivery practical musicianship courses as well as graded courses for beginners’ levels (Music grades 1-3) and intermediate levels (Music grades 4-5) in keyboards, guitar, bass guitar as well as vocals with music theory. CICOM also offers, practical musicianship in contemporary drumming. All classes are delivered on Saturday's morning and afternoon commencing in September 2019.

Completing this form is your request for more information only and does not register you for any lesson, courses or programmes with CICOM. You will be contacted by one of our staff to come for an open day in due course. Note: to be enrolled in any CICOM programmes, it is a requirement that all students have access to their instrument for personal practice away from the classroom and acceptance into CICOM will be significantly based on this essential requirement. (Approved Instruments may also be purchased from CICOM. Information is available on request).

Tel: +44 (0) 7960 185 212. E: cicomlessons@gmail.com. W: www.cicom.co.uk
For more information please visit our CICOM brochure: www.cicom.co.uk

Leave your email address next and complete the rest of this form. Thank you again and we look forward to having you at CICOM. (A responsible adult is required to fill in this form if the student is under 16 years of age. Currently CICOM is only accepting student who are 16+ in 2019. All courses are currently 12 weeks long).

Email *

CICOM

Name *

Phone number *

(Fill one form per person) What age is the person filling in this form? *

Under 16 (if this is selected we will not be able to process this request)

Over 16

What Course Is Required? *

Keyboards

Bass Guitar

Rhythm Guitar

Drums

Vocals

Other:

Intended level of teaching required *

Beginners Level

Intermediate Level

Other:

What age is the intended student? *

11-15 years

16-18 years

19-21 years

22-25 Years

26-30 years

31+ Years

Other:

Do you have a instrument to practice with? *

No (an instrument for personal practice will be needed to enrol in CICOM)

Yes

CICOM Services and Facilities *

Would you like CICOM to recommend as suitable instrument?

Would you like to purchase as suitable instrument from CICOM?

Do you need professional graphics design and printing services? (Authorised Supplier: Canopy Design Graphics)

Do you need professional photography services?

Do you need professional video and multi-media services?

Other:

Required

When is the best time to contact you? *

I give you permission to contact me using the following options:

On my mobile (the number submitted):

Mon. to Fri. mornings after 10am - 12.30pm

Mon. to Fri. afternoons 1pm - 5pm

Mon. to Fri. evenings 6pm - 8pm

Sat. mornings after 10am - 12.30pm

Sat. afternoons 1pm - 5pm

Sat. evenings 6pm - 8pm

By email

Other:

Required

Comments, questions or queries

Consent

I understand that I am providing my details and other information for the purpose of finding out more about CICOM courses, programmes, enrolment, services, facilities and employment. I understand that all data is treated with the utmost care and confidentiality and is securely handled by authorised parties in CICOM only.

A copy of your responses will be emailed to the address you provided.

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