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Suzuki - PDApplication Form

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Suzuki - PDApplication Form
Presented by
Suzuki Talent Education Association of Australia (Vic) Inc
Reg. No. A5744 ABN 14 080 413 955
Closing date for Enrolments 5 March 2004
Suzuki Music
170 Southbank Blvd, Southbank, Victoria 3006
Phone 03 9681 6933 Fax 03 9681 6977
Contact Details
Given Name ________________________ Family Name _____________________________ Membership Number __________________
Address ______________________________________ Suburb _______________________ State _________ Postcode ___________
Phone Home ____________________ Work ____________________ Mobile _____________________ Fax___________________
Enrolment Details
Accredited Suzuki Teacher
Teacher Trainee
(please tick one)
Instrument ______________________________________ Accreditation Level ___________________________________
Instrument ______________________________________ Accreditation Level ___________________________________
Private Lessons
I would like a 30 minute private lesson (Cost $72 with International Tutor, $48 with Australian Tutor). Please note that lessons are limited and
will be allocated in order of receipt.
My preferred tutors are:
1. ____________________________________________ 2. ____________________________________________
Enrolment at the Autumn Festival is open only to financial members of Suzuki Music. You may subscribe or renew membership by
including subscription payment with your enrolment.
Please enter the amount due in the right hand column and the total amount at the bottom.
Suzuki Music Membership
Renewing Members
Amount Payable
Membership (1 year)
ISA Membership (optional)
PD Registration
(until 5 Mar)
Early Bird
(until 6 Feb)
Amount Payable
Professional Development
(Includes lunch each day)
Late fee (after 05 March)
Private Lesson - Int'l Tutor
Private Lesson - Aust Tutor
Payment Details
Cheque payable to Suzuki Music Credit card BANKCARD / MASTERCARD / VISA
Card Number
_ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _
Expiry date
_ _ / _ _
Name of Cardholder
Primary trainees
enrolled in the first year of their
course in 2004 are eligible for a 50% rebate of the
Early Bird rate after completion of a minimum of 10
hours of voluntary work for the Autumn Festival.
Please contact the office to register your interest.

Victorian Teacher Trainers who will be attending
ARE required to register but do not pay for
Professional Development.
Interested teachers who are not accredited or trainee Suzuki teachers may enrol as teacher observers on the appropriate
enrolment form.

Other Documents:
PD Calendar 2004, Piano Pulse Workshop, Auditionform 2005 PDF 001, Teacher Trainee Membership 2004, Volunteering with Suzuki Music, 147174 Swift, 147177 Grand Vitara, 147179 Liana, jobs, 2002 bandit, 2002 dl 1000 all, 2002 gs 500, 2002 lc, 2002 ltz 400, 2002 oil chemicals, 2002 ozark, 2002 racer apparel, 2002 style performance, 2002 sv 650, 2002 tl 1000, 2002 vl, gdsch 03, frm mx 03, bro gsx 1000, app, 2002 gsxr, 2002 hayabusa, 100 Gas Card Promo, Suzuki Entry, Good Scholar Form, MXCB 04 Form, OFFROAD 04 Form, frm mx, frm mx 01, frm offrd, bro kingquad, bro qu 160, bro int 800, bro mar 800, bro sav 650, bro dr 200, bro tl 1000s, bro gsx 600, bro gsx 750, bro qu 400, bro qu 400f, bro qu 4wd, bro qu 500, bro quking, qu 500a,

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