Register #8792 - vancomusic

Registration Form

I am a:

Parent / Guardian

Student Information

First name:

Dylan

Last name:

Zhang

Date of Birth:

2016-05-23

Parent Information

First name:

Grace

Last name:

SUN

Parent / Guardian's Email:

sunguoting@gmail.com

Contact Number:

6047642981

Relationship to student:

Mom

Address

Country:

Canada

City:

COQUITLAM

State / Province / Region:

BC

Address Line 1:

1624 plateau crescent

Address Line 2:

ZIP / Postal Code:

V3E 3B3

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?

Twice a week

Which days are you available for lessons?

Wednesdays, Thursdays

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

Search Engine (Google, Bing, etc.)

Referrer: