Parent Contact Details
Given Name _______________________________________ Family Name _______________________________________
Address ________________________________________________________________ Suburb _________________________
State __________ Postcode ____________ Email _____________________________________________________________
Phone (H) ___________________________ (W) _________________________ (M) __________________________________
MINI FESTIVAL 2006 and
GRAND ANNUAL CONCERT 2006
Closing Date: Friday 8 September
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 8 September)
Private Lesson (Violin and Viola 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 8 September 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