Application Form
For new applicants expressing interest in joining a MYME Ensemble/Band
Applicant Details
Details of student or musician applying for a MYME Ensemble/Band
Applicant 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
Primary Mobile Phone Contact
Format: (000) 000-0000.
Do you have a sibling in MYME?
*
Yes
No
If "Yes", what is the name of your sibling/s?
I am applying for:
*
MYSO 1
MYSO 2
Fiddle Group
Chamber Strings
Concert Band
Senior Brass Band
Current School/College
*
Please write "nil" if not applicable
Current Year level
*
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
College/University/TAFE
Adult Musician
Current Instrumental Music Teacher and/or Private Instrumental Tutor
*
Please write "nil" if not applicable
School/College next year
*
Please write "nil" if not applicable
Instrument/s
*
Do you own or have access to your own instrument?
*
Yes
No
Years on instrument/s
*
Approx. AMEB Level or Instrumental Music Curriculum Level (if known)
*
Parent/Guardian or Emergency Contact Details
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Primary Emergency contact
Format: 0400-000000.
Name 2 (optional)
First Name
Last Name
Email 2 (optional)
example@example.com
Phone Number 2 (optional)
Secondary Emergency contact
Format: 0400 000000.
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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Submit
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