Registration Form

I am a:

Parent / Guardian

Student Information

First name:

Radin

Last name:

SharifiBoroojerdi

Date of Birth:

2009-11-09

Parent Information

First name:

Farid

Last name:

SharifiBoroojerdi

Parent / Guardian's Email:

faridsh121@yahoo.com

Contact Number:

4378787121

Relationship to student:

Father

Address

Country:

Canada

City:

Toronto

State / Province / Region:

Ontario

Address Line 1:

73 Santa Barbara road

Address Line 2:

ZIP / Postal Code:

M2N 2C3

Program Selection

I am looking for:

Online Lessons

What level would you like to register?

Level 5-8

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?

Tuesday

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

Search Engine (Google, Bing, etc.)

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