CNCM Coaching Class Registration Form

Please fill out all fields on this form and submit with PayPal payment to CNCM.

Venue Requested

COACHING CLASSES WILL BE SCHEDULED AT THIS VENUE OR A VENUE IN THE CLOSE PROXIMITY

Venue is subject to approval by CNCM

Coaching Class Session: Winter Spring Summer

Deadlines: Winter (Dec 1, 2024); Spring (Mar 1, 2025) Summer (Jun 1, 2025)

Please contact the registrar office if you would like to host a coaching class session at a time not listed above.

Code: Grade Candidate Number:

Student Information: NEW New Address

Birthday:

STUDENT CONTACT INFORMATION

**Please enter student's name, not parents.

Student's Surname: Student's Given Name and Middle Initials Street Address: City: Province: Postal Code: Telephone: email:

TEACHER INFORMATION

NEW TEACHER CHANGE OF TEACHER New Address Surname: First Name and Middle Initials Street Address: City: Province: Postal Code: Telephone: email: Title(s) of Piece(s), Composer(s): TOTAL FEE ENCLOSED: