Student Details
First Name
*
Last Name
*
Date Of Birth
*
Mobile Phone
School
*
Please choose...
Bangalow Public School
Brunswick Heads Public School
Byron Bay Public School
Byron Community Primary School
Clunes Public School
Corndale Public School
Dunoon Public School
Eureka Public School
Kyogle Public School
Modanville Public School
Mullumbimby High School
Mullumbimby Public School
Upper Coopers Creek
Wyrallah Road Public School
Year
*
Please choose...
Kindergarten
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Year 11
Year 12
Statistical Data
Gender
*
Male
Female
Other
School Level
*
Please choose...
Primary
High School
Preschool
School Type
*
Please choose...
Government
Non-government
Home schooled
Is the student of Aboriginal or Torres Strait Island descent?
*
Yes
No
Is the student from language backgrounds other than English?
*
Yes
No
Does the student have a disability?
*
Yes
No
Medical
Account Holder
First Name
*
Last Name
*
Mobile Phone
*
Home Phone
Email
*
Street
*
Suburb
*
State
*
Please Choose...
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Postcode
*
Emergency Contact
First Name
Last Name
Mobile Phone
Enrolment Details
Please
check here
for instruments offered at your school!
Individual Lesson
Are you enrolling in an individual or shared lesson?
*
Individual
Shared
Neither
Instrument
*
Please Choose...
Drums
Bass Guitar
Guitar
Ukulele
Piano
Keyboard
Voice
Violin
Viola
Cello
Recorder
Flute
Clarinet
Oboe
Saxophone
Trumpet
Trombone
French Horn
Please
check availability
Ability
*
Please Choose...
Beginner
Intermediate
Advanced
Do you need to hire an instrument?
*
Yes
No
Additional Notes
Ensembles
Are you enrolling in an ensemble?
*
Yes
No
Ensemble
*
Please Choose...
Byron Bay > Senior Band
Byron Bay > Intermediate Band
Byron Bay > Beginner Band
Ability
*
Please Choose...
Beginner
Intermediate
Advanced
Do you need to hire an instrument?
*
Yes
No
Additional Notes
Creative Kids Voucher
We are pleased to be a registered provider for the NSW Government's Creative Kids Programme. PLEASE NOTE vouchers apply to the calendar year in
which they are issued.
Further details and an application form can be found
here
. If you would like to apply a voucher to this enrolment, please forward the email you received from Service NSW directly to
admin@nrcac.edu.au
.
Permission to Publish
We would appreciate your permission to obtain and publish CONTENT that may include your/your child’s image and/or name in our publicly available COMMUNICATIONS. COMMUNICATIONS include – but are not limited to – print media, television and video, radio, and publicly available websites. CONTENT includes – but is not limited to – photographs, text, illustrations and graphics, videos, sound recordings, and examples of participants work.
Please note that in some instances, withholding your permission to publish may prevent your full participation in all aspects of the Music In Schools program.
I agree to provide authority to publish:
*
Yes
No
How did you find out about us?
*
TV
Radio
Press
Website
Facebook
Instagram
YouTube
App
Billboard
Public Performance
Word of Mouth
Terms & Conditions
*
I have read and agree to the terms & conditions
Security Test: What is 2 x 4?
*
SUBMIT FORM
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