Application Form for Audition/Interview

Applications for academic year 2012/13 are now open. Please contact sms@lcm.ac.uk for more information.

Fields marked with a * are required

Application for:

Saturday Music School

SMSPlus

(please tick one or both)

First Name *

Surname *

Male/Female

Date of Birth

Year

Month

Day

Age (as at 31.8.11) *

Address *

Town/City *

Postcode *

Telephone *

Email *

Confirm Email *

Instrument/Voice *

Standard

Group Members (If Applicable)

Group Member 1

Group Member 2

Group Member 3

Group Member 4

Group Member 5

Group Member 6

School Attending (as at September 2012)

Name of Music Teacher/Head of Music

Parent/Carer's name

How did you find out about Saturday Music School?

If other please state here

Accessibility - If you require any special arrangements to access the Saturday Music School please enter them below along with any medical conditions and allergies.

yes

I give my consent in accordance with the principles of the Data Protection Act 1998 for my personal details to be held by Leeds College of Music for the purpose of marketing. I may withdraw my consent for the College to hold this information at any time.

For more information on the Data Protection Act visit: www.dataprotection.gov.uk

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Application Form for Audition/Interview