Parent Contact Details
Given Name _______________________________________ Family Name _______________________________________
Address ________________________________________________________________ Suburb _________________________
State __________ Postcode ____________ Email _____________________________________________________________
Phone (H) ___________________________ (W) _________________________ (M) __________________________________
MINI FESTIVAL 2007 and
GRAND ANNUAL CONCERT 2007
Closing Date: Friday 20 July
Total Number of students enrolled _______________
Cheque payable to Suzuki Music OR
Credit card * BCARD / MCARD / VISA
* Card transactions will incur an additional 2% surcharge
_ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _
_ _ / _ _
Name of Cardholder ____________________________Signature ______________________________________
Mini Festival Fees and Grand Annual Concert Tickets
Please enter the amount due in the right hand column and the total amount at the bottom.
Mini Festival Program
Subtotal A (Program Costs):
Late Fee (after 20 July)
(Violin, Viola and Cello only
Afternoon Tea (Cake and Juice)
Grand Annual Concert Tickets
Cost per ticket
(holders of Seniors Cards only)
Family (2 Adults + 2 Children)
Subtotal B (Ticket Costs):
TOTAL AMOUNT PAYABLE (Subtotal A + Subtotal B): $
You must be a financial member of Suzuki Music to participate in this event. You may attach a completed
membership form to this application.
Please assist organisers by ensuring that this form is completed correctly. Incomplete forms will be returned.
Mini Festival Cancellations received by Friday 20 July will be refunded less a $15 administration fee per child. No
refunds will be made after this date for any reason.
Grand Annual Concert tickets are non-refundable.
PO Box 439 Kew East Vic 3102
Phone 03 9859 0433 Fax 03 9859 0477 firstname.lastname@example.org
Suzuki Talent Education Association of Australia (Vic.) Inc. A5744 ABN 14 080 413 955