JMI Private Lesson Registration Form

JMI PRIVATE LESSONS REGISTRATION FORM

PLEASE NOTE:

– Please complete all questions and click the “Submit” button at the bottom of the page to register for JMI’s Private Lesson Packages. Once submitted, JMI will contact you directly to confirm your registration.
– By submitting this form, you are agreeing to pay the lesson fees for your Private Lessons Package.
– Once you submit this form, JMI will send you an invoice for the registration fee that is payable within 30 days of receipt.

How did you hear about JMI?*

Please select your preferred teacher*

Please select the number of lessons you would like*

First Name*

Last Name*

Preferred Name

Your Email*

Mobile*

Date of Birth (DD/MM/YYYY)*

Address line 1*

Suburb/Town*

State*

Postcode*

Country*

What instrument do you play?*

How many years have you been playing?*

Please list any previous music education you have completed (optional)

Would you like to join our mailing list? Please choose the categories that you wish to receive more information about (optional) Would you like to join our mailing list? Please choose the categories that you wish to receive more information about (optional) JMI Live & Gigs JMI Courses & Classes Essentially Ellington

Emergency Contact Name*

Relationship to this person*

Emergency contact number*

Permission Permission I give permission to JMI to use any images or videos of myself collected in classes or performances for social media and other marketing purposes (optional)

I declare that the information on this form is, to the best of my knowledge, true in every respect. I declare that the information on this form is, to the best of my knowledge, true in every respect. I declare that the information on this form is, to the best of my knowledge, true in every respect.

I declare that by completing this form I agree to pay the $440 registration fee for JMI's Night Classes in 2021. (JMI will send you a confirmation of your registration within 2 working days. An invoice will be sent to you payable prior to the commencement of classes) I declare that by completing this form I agree to pay the $440 registration fee for JMI's Night Classes in 2021. (JMI will send you a confirmation of your registration within 2 working days. An invoice will be sent to you payable prior to the commencement of classes) I declare that by completing this form I agree to pay the lesson fees for this Private Lessons Package. (JMI will send you a confirmation of your registration within 2 working days. An invoice will be sent to you payable on receipt. Payment must be received prior to receiving lessons.)

Refunds Refunds I acknowledge that there are no refunds available for this lesson package, except for in the event that JMI is unable to provide a teacher to deliver this package.

Cancellations Cancellations I acknowledge that lesson cancellations must be made more than 24 hours prior to the arranged lesson time. Lessons cancelled within 24 hours will not be redeemed.

JMI Private Lesson Registration Form

JMI PRIVATE LESSONS REGISTRATION FORM

Contact info

07 3216 1110

play@jazz.qld.edu.au

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