Music Lesson Registration Register For Music Lessons With MLC Academy Are you interested in taking lessons at MLC-Academy? Please complete this form and a member of our team will contact you as soon as possible. Please be as specific as possible, the more information you give us, the better we can serve you. Step 1 of 4 25% About YouPerson completing this form, EG parent/carer/relativeName* First Last Contact Phone Number*Email Address* Address* Street Address Address Line 2 City County Postcode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country About The StudentOnly complete this section if the lessons are for someone other than you.Student Name First Last AgeTell us about your abilities so far.Have you played before?*What is your abilityComplete BeginnerCompetent BeginnerPlayerRock GodIf you have played before, please tell us how long you've been playingSelect one pleaseUnder 2 Years3 to 5 years5 years plusHave you taken any music qualifications?These include graded exams, BTEC, GCSE and so on. Please state belowTell us about you and your musical influences Lessons, Courses and ProgramsInstrument (ONE TO ONE LESSONS ONLY)*Please tell us which instrument you would like to study.BassDrumsGuitarSingingPianoKeyboardMusic ProductionGroup SessionsONLY use this section if you would like group lessons and/or coursesSummer School 2017Master ClassesClinics/WorkshopsEuropean ExchangeGraded CoursesIf you require a specific teacher, please state here.Have you been recommended to a specific teacher at MLC? Waiting times may increase Your AvailabiltyWhich centre would you like to study at?*Group courses - limited availability at Abbey RoadCastle Boulevard (city centre)Abbey Road (West Bridgford)AnyWhat days best suit you for lessons?*The greater your flexibility, the quicker we can get your lessons started Monday Tuesday Wednesday Thursday Friday Saturday What time best suit you for lessons?*The greater your flexibility, the quicker we can get your lessons started Daytime weekday (12pm to 4pm) Peak time after school weekday (4pm to 9pm) Peak time after school weekday (5:30pm to 9pm) Weekend early bird (10am to 1pm) Weekend afternoons (1pm to 5pm) Schedule varies. Chat with MLC about this Additional informationTo help us better serve your needsWhere did you hear about MLC-Academy?* Google Abbey Road Music Friend/Family Social Media MLC Teacher Curly Lead Studios OtherAdditional informationPlease tell us any information that helps us with your inquiry including any special needs EG left-handed player, ability to climb stairs etc.NameThis field is for validation purposes and should be left unchanged.