Suite 1, Level 1, 191 Church Street Parramatta NSW 2150
(Opposite Parramatta Town Hall, Near Children's Playground)

Call Us: (02) 9687 0304
Mobile: 0426 950 618
Opening Hours: 10am-7pm Open 7 days

Student’s Name:

First              Last
Name of Parent/Guardian (if student is under 18):

First              Last
Student’s Date of Birth:                                   SEX:
/ /                           FM
   DD        MM       YYYY

Contact Phone Number:
Mobile            Home:

Contact Email:  

Home Address:

What Class/Lesson are you enrolling for?

How long do you intend to have lessons for?  

What day of the week do you intend to take lessons?

How did you hear about us?

Please tell us of any medical conditions or any other information we need to know about the student.

I have read and agree to the terms and conditions of Parramatta Academy Music Class (“PAMC”), and understand that any breach of these conditions may lead to disciplinary action, up to and including termination of lessons.