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Suzuki - Application Form PDF (Page 1)

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Suzuki - Application Form PDF
S U Z U K I M U S I C
AUTUMN FESTIVAL 2 0 0 5
Presented by
Suzuki Talent Education Association of Australia (Vic) Inc
Parent contact details
Given Name ________________________ Family Name ______________________________ Membership Number __________________
Address ______________________________________ Suburb _______________________ State _________ Postcode ___________
Phone Home ____________________ Work ____________________ Mobile _____________________ Fax ___________________
Attending adult(s)
Name of each parent or responsible adult attending
Given Name
Family Name
Eligibility
Enrolment at the Autumn Festival is open to financial members of
Suzuki Music. You may subscribe or renew membership by
including a subscription payment with this enrolment.
is y subscribe
Fees
Please enter the amount due in the right hand column and the total amount
at the bottom. All prices include GST.
Please complete a student details form (see
reverse side of this page) for each student
attending.
Total number of students enrolled: _________
Payment Details
Cheque payable to Suzuki Music OR
Credit card BANKCARD / MASTERCARD / VISA
Card Number
_ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _
Expiry date
_ _ / _ _
Name of Cardholder
__________________________________
Signature
____________________________________________
Assistance required
For a smooth running Autumn Festival we need assistance from all
families and teachers. Please indicate below which task(s) you can
assist with either before or during the event. More details available
from the office.
Before Autumn Festival
Putting together confirmation mailout to families
Assembling registration kits
Start of Autumn Festival (Tues, Wed and Thurs)
Signage Set up rooms Registration Desk
During Autumn Festival
Administration tasks
First aid
Selling Suzuki Books and Merchandise
At Conclusion of Festival
Moving Digital Pianos and Keyboards
General packing and clean-up duties
Thank you for your support. You will be contacted by our Volunteer
Co-ordinator to confirm your availability and provide details.
Suzuki Music
Membership
New Members
Renewing
Members
Amount
Payable
Subscription (1 year)
$80
$69
$
Subscription (3 years) $208
$197
$
No. Program
Standard
(until 18 Feb)
Early Bird
(until 10 Dec)
Amount
Payable
Standard Suzuki
$240
$211
$
Young Beginner
$188
$164
$
Advanced Program
$337
$309
$
Early Childhood
$116
$99
$
Sibling
$240
$211
$
Junior Sibling
$188
$164
$
Voice - Baby
$66
$55
$
Subtotal C:
$
No. Extras
Cost
Amount
Payable
Second Instrument Levy
$26
$
Private Lesson (Int'l tutor)
$78
$
Private Lesson (Aust tutor)
$52
$
Late Fee (after 18 Feb)
$44/family
$
Subtotal B + Subtotal C:
$
10% of Subtotal A if 2 or more children enrolled $
TOTAL AMOUNT PAYABLE
$
Subtotal A: Program Costs $
Subtotal B: Subtotal A - Discount (if applicable) $
STUDENT ENROLMENT
Closing date for Enrolments 18 February 2005
Suzuki Music
170 Southbank Blvd Southbank Victoria 3006
Phone 03 9681 6933 Fax 03 9681 6977
info@suzukimusic.org.au

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