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Music Services – Accessible music learning (AML) sign up – FORM
Accessible Music Learning
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Are you making a referral for Accessible Music Learning for yourself or somebody else?
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I’m referring myself
I’m referring someone else
1. Please tell us your name.
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First
Last
2. What is your email address?
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3. What is your phone number?
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4. How old are you?
Under 4
5 – 11
12 – 19
20 – 35
36 – 50
51 – 64
65+
5. Please tell us a little about why you're enquiring about Accessible Music Learning.
6. Do you have a specific instrument(s) you would like to learn?
The instruments we currently teach and the days which they are available are listed below.
Voice (Monday, Tuesday)
Violin (Tuesday, Friday)
Guitar (Tuesday, Friday)
Piano (Monday, Tuesday, Friday)
7. Availability.
Please provide details of days/times that are
not
suitable for you.
8. Is there anything else you'd like to share with us that you feel we need to know?
About you
1. Please tell us your name.
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First
Last
2. What is your email address?
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3. What is your phone number?
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About the person you’re referring for Accessible Music Learning
4. Please tell us the name of the person you’re referring.
First
Last
5. What is your relationship to the person you’re referring?
6. How old is the person you're referring?
Under 4
5 – 11
12 – 19
20 – 35
36 – 50
51 – 64
65+
7. Please tell us a little about why you're referring this individual for Accessible Music Learning.
8. Does the person you’re referring have a specific instrument(s) they would like to learn?
The instruments we currently teach and the days which they are available are listed below.
Voice (Monday, Tuesday)
Violin (Tuesday, Friday)
Guitar (Tuesday, Friday)
Piano (Monday, Tuesday, Friday)
9. Availability.
Please provide details of days/times that are
not
suitable for the person you’re referring.
10. Is there anything else you'd like to share with us about the person you’re referring that you feel we need to know?
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