Swashraya Musical

Student Entry Form

Note:-

All lessons are required to be paid in advance by a full term upfront via credit to bank account or Cash to Swashraya Musical. Refer to Our Terms & Condition
( Bankwest : BSB: 306 074 Account No: 0868176 Ref: Student's Name)

* indicates required

Student Name *

Date of Birth *

DD/MM/YYYY

Parent/ Guardian Name *

Address

Street Address Address Line 2 City State/Prov/Region Postcode Country

Phone Number *

Email Address *

Occupation

Emergency Contact Name *

Emergency Phone No

Phone nos for next of Keen

Consent

I hereby give my permission for photography for Newsletter and publication on social media.