Child:_____________  Age of child____ (D.O.B.)_______Parent:______________

Contact phone number:_________ Mobile:____________

Class required: Day____________ Time_________ Venue___________

*Email address: ___________________________________________________

receive e-newsletter from Music Works –Let’s Sing!

Payment for 12 classes $168 commencing Friday 04/03/08- Thursday 28/06/08

Insert ü as  required:   Cash: ¨ Cheque: (made to Music Works) ¨ Visa¨ Mastercard ¨

Card number:_ _ _ _  _ _ _ _  _ _ _ _  _ _ _ _

Expiration: _ _/_ _ Name on card_____________________ Total:$__________

Signature:_____________________

(please note that there is a strict no refund policy once payments are put through and a $10 administration fee applies

where fees are not submitted within 3 weeks of commencement of classes.)

Bookings essential ph:9029 6879 or 0425 85 40 20 or send with payment to

28 Gladstone Pde Elsternwick 3185, fax to 9532 7010 or give this form and payment

to your child’s teacher as soon as possible.

Music Works-Let’s Sing! End of term 1 concert Sunday 16^th March 10.30-11.30am

at Sholem Aleichem College Hall 11 Sinclair St Elsternwick….come join us!

End of term 2 concert Sunday 22^nd June 10.30-11.30am venue to be announced.

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