Register #8775 - vancomusic

Registration Form

I am a:

Parent / Guardian

Student Information

First name:

Teo

Last name:

Kim

Date of Birth:

2019-10-26

Parent Information

First name:

Jung

Last name:

Kim

Parent / Guardian's Email:

johdesign@hotmail.com

Contact Number:

778.846.5864

Relationship to student:

Parent

Address

Country:

Canada

City:

Port Moody

State / Province / Region:

BC

Address Line 1:

28 Arrow Wood Place

Address Line 2:

ZIP / Postal Code:

V3H 4J1

Program Selection

I am looking for:

In-person Lessons

What level would you like to register?

Preliminary

Please write the program or instrument you are interested in:

Piano

How many days a week would you like to have classes?

Once a week

Which days are you available for lessons?

Monday, Tuesday

We'd love to know how you heard about us:

Search Engine (Google, Bing, etc.)

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