Summer Classes Form

Student Gender:
MaleFemale

Student Surname (required)

Student Name (required)

Student Date of Birth (required)

Student Fathers Name (required)

Student Mother Name (required)

Student Phone Number (required)

Parent/Guardian Phone Number (required)

Student Address (required)

Student Post Code (required)

Your Email (required)

I am interested in: (required)
Classical PianoModern PianoClassical GuitarElectric GuitarAcoustic GuitarModern GuitarSingingElectric BassUkeleleDrumsMusic Theory(Greek System)Music Theory(ABRSM)History of MusicInstrumentationSolfege/DicteeOther

What are your hobbies? What do you like to do during your free time?

Bared on your character and knowledge how do you think you might help Potenzia Summer School?

What do you expect to gain from Potenzia Summer School Activities?

Other (If applicable)

Please note whether the student has a condition that we need to be aware of(If applicable)

Please note if there the student has learning problems and clarify(if applicable)

With my signature, I agree to include the registered student in any publication and/or other productions, which aim to promote Potenzia del’ arte, without any demand.
I accept all terms and conditions of the school.
We will review your request and communicate with you. For group classes please make sure you have seen the program by clicking here.