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AcceptanceI have read and understand the terms and conditions for participating in the Dominic College Individual Music Tuition Program

Student Given Name

Student Family Name

Student Year Level

Student Oratory Group

Parent / Guardian Given Name

Parent / Guardian Family Name

Parent / Guardian Phone Number

Parent / Guardian Email Address

Name of person responsible for paying account

Email address of person paying the account

Phone number of person paying the account

Instrument Choice

Lesson Type

Individual

Shared

How many years experience on this instrument

Any comments, requests or information the instrumental teacher would benefit from knowing