Student's Name *

First Name

Last Name

Date of birth *

MM

DD

YYYY

Lesson *

Piano

theory

drums

violin

cello

Parent's Name *

First Name

Last Name

Phone *

Country

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Please read before submitting your form: *

All our lessons are one-on-one and we approached each students differently with personalised plans. To support this, SAMPA charges a small $50 ADMIN FEE per term, this covers all communications, scheduling, and re-scheduling in case of sickness or other commitments.

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