Language
English (Australia)
Application Form
For new applicants
Applicant Details
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
*
-
Day
-
Month
Year
Date
Email
*
example@example.com
Phone Number
Do you have a sibling in MYME?
Yes
No
Sibling's name?
I am applying for:
*
MYSO 2 (Junior Strings)
MYSO 1
Concert Band (MYCE)
Fiddle group
Chamber Strings
Junior Brass Band
Senior Brass Band
Current School/College
*
School/College next year
*
Year level
*
Please Select
3
4
5
6
7
8
9
10
11
12
College/university
Music teacher
Do you own or have access to your own instrument?
Yes
No
Instrument/s
*
Years on instrument/s
*
Instrumental Music teacher (please write "nil" if not applicable)
*
Private Music Tutor (please write "nil" if not applicable)
*
Approx. AMEB Level (if known)
Emergency/ next of kin contact details
Parent/ Guardian details (under 18's)
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Primary Emergency contact
Name
First Name
Last Name
Email
example@example.com
Phone Number
Secondary Emergency contact
Billing details
All successful applicants will be emailed an invoice upon successful acceptance to MYME. Please provide a MONITORED email address for billing purposes.
Billing Email address
*
Please provide a monitored email address
By checking this box, I confirm that I am over 18 years of age or have parental/guardian consent to apply for MYME. I also understand that submitting this application form does not guarantee acceptance into MYME.
*
Yes
Date
*
/
Day
/
Month
Year
Date
Hour Minutes
AM
PM
AM/PM Option
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