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Group Class Enrolment 2024/2025
This form is for GROUP classes only - If you are looking for Private (one on one) lessons please fill in the form here -
https://forms.gle/f19MtSqMiecK2sdK7
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Email
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Your email
STUDENT INFORMATION
Student First Name
*
Your answer
Student Surname
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Your answer
How old is the student?
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Your answer
Date Of Birth
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MM
/
DD
/
YYYY
Address
*
Your answer
Parent / Guardian Name
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
How did you hear about Mezzo Music Academy?
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Your answer
Do you wish to rent an instrument from Mezzo for the term?
*
Yes
No
Does the student have a medical condition, or any additional learning or behavioural needs?
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Yes
No
If yes, please give details. This information will be treated with the strictest confidence. It is important that the teacher is made aware of any circumstances which might affect the student's wellbeing, behaviour, or ability to learn.
Your answer
Please describe the student's previous musical experience, if any.
Your answer
CLASS SCHEDULING
Small Group Classes (ages 5-7) - Select one Instrument ONLY.
For Pre-instrumental (ages 4-6, exploring different instruments weekly) please select in courses section below)
Piano
Singing
Percussion
Guitar
Ukulele
Violin
Recorder
Select Course(s)
Music Theory
Kindermusik (ages 0 - 4)
Pre-Schoolers (ages 3 - 4)
Pre-Instrumental (ages 4 - 6)
Junior Choir (ages 4 - 10)
Jam Session (ages 12 - 14)
Jam Session (ages 15 - 17)
Junior Cert Grind (private)
Junior Cert Grind (group)
Leaving Cert Grind (private)
Leaving Cert Grind (group)
Leaving Cert Music as external subject (private)
Leaving Cert Music as external subject (group)
Day & Time Preference (please choose at least 3 options)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
9am - 11am
11am - 1pm
1pm - 3pm
3pm - 5pm
5pm - 7pm
7pm - 9pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
9am - 11am
11am - 1pm
1pm - 3pm
3pm - 5pm
5pm - 7pm
7pm - 9pm
Any additional information regarding day & time slots:
Your answer
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