Student Registration Form

Student Registration Form
Student's Name*

PrefixFirst NameLast Name
Age*
Designation*
Student, businessman, artist, professional, govt. employee, housewife etc.
Guardian's Name (if student is a minor)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mobile Number*
Alternate Number
if any
E-mail
If any
Instrument*

GuitarClassical GuitarBass GuitarPianoKeyboardVocalDanceOthers
Course*

ContemporaryIndian ClassicalWestern Classical
Branch*

GuwahatiShillongBangaloreOther
Previous course(s) in music (if any)
Signature (your full name)*
Type your full name in the box
Should be Empty: