Application Form - Please refer to 'Timetable' page when completing

WMA SUMMER SCHOOL OF MUSIC 11 to 18 AUGUST 2018

APPLICATION FORM

 

 

Name   

 

Postal Address                                                                                                                                                        

                                                                                                                                    Postcode

 

E mail Address                                                                     phone

 

Age   Under 14             14-17        18-35          36-51            52-70        70+

 

Accommodation          Single                   Twin/small shared           Shared /camping               Day student

 

                                         Camping            

 

Disabilities       Please specify any particular needs

 

Diet                   Vegetarian                         Vegan                  Gluten                 Special

 

Voice                Soprano                             Alto                      Tenor                   Bass

Course                                                          Instrument /s       

 

1

 

2

 

3

 

4

 

     

 

YOU ARE EXPECTED TO ATTEND ALL SESSIONS OF THE COURSES FOR WHICH YOU ENROL. PLEASE REFER TO THE TIMETABLE BEFORE COMPLETING. IF YOU ENROL ON COURSES THAT COINCIDE YOU MUST AGREE WITH THESE COURSE TUTORS SO THAT THEY CAN PLAN THEIR COURSE PROPERLY.

 

Sleeping:                                   Early Bird                  Night Owl

Special requirements: Please specify on reverse of this form

Ingestre Hall has facilities for students with special needs/disabilities.

Transport; Do you require local transport from Stafford to Ingestre Hall?

 

I wish to attend the WMA Summer School of Music 2018;

 I enclose a cheque for £60 deposit/ I have paid by Bank Transfer. (details below)                                                             The balance to be paid by 6 July 2017.

Account name  WMA Summer School of Music.

Signed                                                             Print Name                                                Date

Return to; WMA Summer School 8 Beverley Rd Liverpool L15 9HF

IN AN EMERGENCY

If you wish you can provide contact details of;

(1)your next of kin,

(2) your GP, and

(3) any medical details likely to be of importance in an emergency. e.g. allergies, medication

Copy and paste your application form into Word for completion. Return to the address above before 31 March 2018for a £20 discount. If you wish to pay by Bank Transfer our details are;    Co operative Bank  Account No: 65079348             Sort Code: 08 92 99.     Please identify the payment with your name and e mail rob.harper5744@myphone.coop with advice of the payment.

Ingestre Hall