DEMINORS MUSICAL SUMMER FOR CHILDREN
Ikota Shopping Complex, Ajah. 08067536220. deminors@yahoo.com
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APPLICATION FORM
WARDS PERSONAL DATA
SURNAME:
GENDER:
--Select--
Male
Female
OTHER NAMES:
RELIGION:
--Select--
Christianity
Muslim
Others
SCHOOL:
CLASS:
DATE OF BIRTH:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
5%
29
30
31
Jan.
Feb.
Mar.
Apr.
May.
Jun.
Jul.
Aug.
Sep.
Oct.
Nov.
Dec.
PECULIARITY:
PARENTS DATA
(Please fill correctly the parents or guidians personal datat)
NAME:
ADDRESS:
TELEPHONE NUMBER:
E-MAIL:
CHILDS AREA OF INTEREST
(Please select the type of instrument or instruments the child wants to apply for. or enter a new one if the area of interest is not in the list)
Violin
Piano
Gitar
OTHER INSTRUMENTS:
DECLARATION:
I certify that the above information is correct and promise to abide by the Rules and Regulations of DEMINORS
©2008
esNICOM