Registration Form

I am a:

Parent / Guardian

Student Information

First name:

Alvin

Last name:

Han

Date of Birth:

2008-03-19

Parent Information

First name:

Juhee

Last name:

Lee

Parent / Guardian's Email:

jh.lee11312@gmail.com

Contact Number:

6049773883

Relationship to student:

Mom

Address

Country:

Canada

City:

Coquitlam

State / Province / Region:

BC

Address Line 1:

2303

Address Line 2:

3007 Glen Drive

ZIP / Postal Code:

V3B 0L8

Program Selection

I am looking for:

In-person Lessons

What level would you like to register?

Level 1-4

Please write the program or instrument you are interested in:

Violin

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

Once a week

Which days are you available for lessons?

Monday

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

Search Engine (Google, Bing, etc.)

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