JMI Remote Registration Form REGISTER FOR JMI REMOTE PLEASE NOTE: – Please complete all questions and click the “Submit” button at the bottom of the page to register for JMI Remote. Once submitted, JMI will contact you directly to confirm your registration.– By submitting this form, you are agreeing to pay the registration fee for the JMI Remote.– Once you submit this form, JMI will send you an invoice for the registration fee that is payable prior to commencing your JMI Remote course. How did you hear about JMI?* First Name* Last Name* Preferred Name Mobile* Your Email* Date of Birth (DD/MM/YYYY)* Address line 1* Suburb/Town* State* Postcode* Country* What instrument do you play?* What are you looking to learn in your JMI Remote course?* How many years have you been playing?* Please list any previous music education you have completed (optional) Please select your preferred payment option* Please select your preferred payment option* Full upfront payment ($440 AUD) Half upfront payment ($220 AUD) remaining payment after 2 lessons Payment per lesson ($110AUD) *note payment required before lesson 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 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. Payment declaration Payment declaration I declare that by completing this form I agree to pay the registration fee for this JMI Remote course ($440AUD). JMI will send you a confirmation of your registration within 2 working days. An invoice will be sent to you with payment instructions Submit
