Suzuki Piano Graduation Form 2005 000 Page 2
TEACHER'S NAME:
__________________________________________________
Phone:
__________________________
FEES
LEVELS 1 2 $55
LEVELS 3 5 $61
LEVELS 6+ $76
Graduation entry fee includes performance at Piano Graduation Celebrations.
All prices include GST.
M/ship
No.
First Name(s)
BLOCK LETTERS
PLEASE
Family Name
BLOCK LETTERS
PLEASE
DOB
Grad Lvl
Live/
Tape
FEES
Total
TIMES TO BE AVOIDED FOR SPECIFIC STUDENTS (Live Graduations) (EXCEPTIONAL CIRCUMSTANCES ONLY)
NAME REQUEST
Teacher's Authorising Signature:
