The Regency Ensemble Contact details Preparatory Courses Intermediate Courses Advanced Courses Adult Workshops

Intermediate Course Application

Please fill in the form below to send an application to Regency Chamber Music. When you have filled in the required fields, click the "Send" button. You will then receive a confirmation email.

Alternatively print this page and send a completed form by post to Regency Chamber Music, 8c Lansdowne Place, London SE19 2UQ.

Intermediate Course Application Form

NAME:

NAME OF PARENT OR GUARDIAN
ADDRESS:
 
 
 
POSTCODE:
TEL NUMBER (Home):
TEL NUMBER (Mobile):
EMAIL ADDRESS:
APPLYING FOR :

June
October

DATE OF BIRTH:
INSTRUMENT:
LAST GRADE TAKEN:

DATE & MARK:

CURRENT TEACHER:

REPERTOIRE PREFERENCES:
OTHER COMMENTS: