Register for the PLAYLOUD Music Instruction Program - Tauber Music School

Use this form to submit an enrollment application for the playLOUD Rock Band program being held from July 10 to July 20, 2017 at the Tauber Music School, 1330 Portage Avenue and 14 Britannica Road locations in Winnipeg. Registration deadline is June 30, 2017.

For program details and eligibility click the following link: playLOUD Rock Band Program.

To help make your experience at playLOUD Rock Band Program more enjoyable, please complete the following form.

Instructions

All information with (*) needs to be filled in for the form to submit successfully.

You may use this form to REGISTER AND HOLD YOUR PLACE on the schedule for the playLOUD Rock Band session.

Once you have submitted this form, you will receive confirmation by return email. Thank you for your business.

For immediate help with any questions you may have, please contact us by phone at (204) 697.4565 or by email to info@taubermusic.com.

Student Interests

Favorite Band(s)

Favorite Song(s)

Favorite Musical Style(s)

Musical Experiences/Goals

Student Information

Student First Name *

Student Last Name *

Mailing Address *

City *

Postal Code *

Current Age of Applicant *

Instrument you play *

Additional Info

Are you currently taking lessons? *

Yes

Contact Info

Contact Name *

Contact Relationship *

Contact Phone (Home) *

Contact Phone (Work)

Contact Cell

Contact Email Address *

Current Date * (DD/MM/YYYY)

Payment Options *

I am currently enrolled in the pre-authorized chequing or credit card plan at Tauber Music School. Please debit my account. Invoice my account*. *Payment must be received in our office no later than June 30, 2017. Pay by credit card over the phone (Visa or MasterCard). Call (204) 697-4565 or (204) 786-1199 to make your payment.

Please note the following conditions: