NB   PLEASE  make sure you choose a class suitable for your capability,
both for your benefit and also for members in your class.

APPLICATION FORM

*Delete as applicable *Mr/Mrs/Miss/Ms

Forename _____________________ Surname  ________________________________________________

Address    ______________________________________________________________________________

Postcode ___________  Tel. No__________________    E mail address____________________________

Diploma _______________________
 
*I wish to enrol with Tutor   lst choice      ___________________________
 
                                                   2nd choice   ___________________________

*I wish to enrol as an Observer   *YES/NO

*I would like vegetarian meals     *YES/NO   

Other dietary requests  ___________________________________________                                        

*I would prefer a room with a BATH / SHOWER in Armitage or Orchard Hall

*I/We would like a double/single/twin bedded room in the Gardner Hotel

*I have paid the deposit of Ł40
*I enclose my deposit for Ł40 made payable to 'Summer School for Pianists'

and note that any balance must be paid by 15th June. 

Signed  _______________________________________    Date  ___/____/________

Please return form to:
Mrs Wendy Wyatt.   96 Arundel Avenue, South Croydon, Surrey CR2 8BE or
E mail to wendy.wyatt@tiscali.co.uk                Tel. 020 8657 7200