Registration Form

I am a:

Parent / Guardian

Student Information

First name:

Daniel

Last name:

Kim

Date of Birth:

2016-03-28

Parent Information

First name:

Sophia

Last name:

Yoon

Parent / Guardian's Email:

yoon1217@gmail.com

Contact Number:

7785805030

Relationship to student:

Mother

Address

Country:

Canada

City:

Coquitlam

State / Province / Region:

British columbia /Vancouver

Address Line 1:

2103-3007 Glen Dr

Address Line 2:

ZIP / Postal Code:

V3B0L8

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?

Tuesday, Fridays

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

Search Engine (Google, Bing, etc.)

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