Enrolment Form for Child Student

Note : In order to complete your registration, please complete this enrolment form & pay the Fees in advance by Online Bank Transfer or Cheque or Demand Draft favouring “LORRAINE MUSIC ACADEMY PVT. LTD.”. You will then be allotted a specific day & time for music lessons as per availability.

Name (Child):

Date of Birth:

Name (Mother):

Date of Birth:

Wedding Anniversary:

Name (father):

Date of Birth:

School Name:

School Address:

Residence Address:

Residence Tel:

Mobile (Mother):

E-Mail (Mother):

Office (Organisation) (Mother):

Designation:

Office Tel:

Mobile (Father):

E-Mail (Father):

Office (Organisation) (Father):

Designation:

Office Tel:

Would you say that your child loves music?

Does he / she sing often? When and why?

Has he / she been fascinated by any singer or musician?

Has he / she shown an interest, longing or desire to play any particular instrument/s?

Has he / she shown an interest, longing or desire to act a part in any play / drama?

What are his / her favourite movies?

He / She likes to :

How did you know about LORRAINE MUSIC ACADEMY?:

What kind of music does your child like? & What kind of music do you / your spouse like? (Please indicate an answer on a relative scale of 1-5)

Western classical

Indian classical

Bollywood

Western Pop

Jazz

Rap

Rock

Spiritual

Any other

What pieces do you want him / her to learn ?

Special information about the child:

Any special request from the parents:

Classes preferred on (day of the week)-1

Preferred time-1:

Classes preferred on (day of the week)-2

Preferred time-1:

Classes preferred on (day of the week)-3

Preferred time-1:

Enrolment Form for Child Student

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