Academy Application Form

Name and Surname:

Place and Date of Birth:

Nationality:

Enrolment:

Select Course:

Level:

1st Instrument:

2nd Instrument (optional):

Preferred days and time:

Lesson lenght:

Collective Course (optional):

Home Address:

Phone/Mobile:

E-mail:

The London Piano Masters reserves the right to make photo, audio and/or video recordings at any time during the course or the performances and to use such recordings for any purposes. Participation in the London Piano Masters Winter Academy constitutes a waiver of all claims and fees for broadcast of any photographic, audio and video content.

I agree to the Terms of the London Piano Masters

Typed Signature of Applicant

or Parent/Legal Guardian

for Students under

18 Years Old