Pupil Registration | Helen M Smith

Please enter your details and I will get back to you with further details.

Pupil Name *

First

Last

Instrument *

School *

Other School

School Name if "Other" selected

Pupil's Date of Birth *

School Year *

3,4,5,6 etc

Class *

Parent/Guardian Name *

Please include Mr/Mrs/Ms etc.

Phone No. *

Mobile if possible.

Parent/Guardian Email *

Confirm Email

Additional Contact Name

Additional Phone Number

Address *

Postcode *

SEN/Medical Needs

If your child has any issues that may affect their learning, please let me know. This may include physical issues such as issues with co-ordination or problems standing for long periods. Feel free to get in touch with me to discuss any concerns.

Existing Musical Experience

Other instrument already or previously played, choir membership etc.

Other information

Any questions you have or additional information you think would be useful.

Interested in hiring an instrument?

Violin
Keyboard (piano)

I have a limited number of violins and basic keyboards for piano pupils available for hire. Please indicate if you are interested in hiring one.