Private Lesson Bookings STUDENTS DETAILSChild #1 - NEW / RETURING*New student to MAPAExisting / Returning studentSTUDENT'S FIRST NAME*STUDENT'S LAST NAME*PREFERRED NAME (Optional)GENDER*FemaleMaleNon-BinaryDATE OF BIRTH*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920ANY ALLERGIES, MEDICAL CONDITIONS, DISABILITIES OR SPECIAL NEEDS?*YESNOALLERGIES, MEDICAL CONDITIONS OR SPECIAL NEEDS:*HAVE YOU HAD ANY PREVIOUS EXPERIENCE?*- please select -YESNOPrevious dance experiencePlease provide some details of previous experience and training including other schools you've trained at and how many years. This will help our teachers ensure new students have a comfortable transition and provide them with any additional support in areas they may need. PRIVATE LESSON DETAILSPLEASE SELECT THE TYPE OF PRIVATE TRAINING YOU ARE AFTER*- Select Private Lesson Type -VocalsPianoDanceActingPlease select the style(s) of dance you are interested in?* Classical Ballet Jazz Contemporary Tap Hip Hop Latin & Ballroom Unsure Other Please specifyPlease let us know what style of dance you are interested in.Please select the style(s) of Singing you are interested in?* Pop Musical Theatre Jazz Contemporary Rock R&B Unsure Other Please specifyPlease let us know what style of singing you are interested in.Please select the style(s) of Piano you are interested in?* Classical Piano Jazz Piano Musical Theatre Piano Pop Rock Piano Unsure Other Please specifyPlease let us know what style of piano you are interested in.Please select what type of acting/drama you are interested in?* Live Stage Film & Television Unsure Other Please specifyPlease let us know what type of acting/drama you are interested in.How often would you like your private lesson to occur?*One off Single LessonCasual (book as you go)Fortnightly LessonWeekly LessonHow long would you like your private lesson to go for?*30 mins45 mins60 mins75 mins90 mins2 hours2 hours 30 mins3 hoursHow long would you like each of your private lessons to go for?*30 mins45 mins60 mins75 mins90 mins2 hours2 hours 30 mins3 hoursHow many lessons do you wish to purchase?Single Lesson3 x Lesson Discount PackageHow many lessons do you wish to purchase?Single Lesson3 x Lesson Discount Package5 x Lesson Discount Package10 x Lesson Discount PackagePrice per lesson Price: $ 0.00 Price per lesson Price: $ 0.00 Total Price Price: $ 0.00 Total Price Price: $ 0.00 Total Price Price: $ 0.00 PREFERRED DAYS & TIMESFirst Preference*- Select Day -MondayTuesdayWednesdayThursdayFridaySaturdayPlease select earliest start time : HH MM AM PM Please select lastest finishing time : HH MM AM PM Second Preference*- Select Day -- Not available any other dayMondayTuesdayWednesdayThursdayFridaySaturdayPlease select earliest start time : HH MM AM PM Please select lastest finishing time : HH MM AM PM Third Preference*- Select Day -- Not available any other dayMondayTuesdayWednesdayThursdayFridaySaturdayPlease select earliest start time : HH MM AM PM Please select lastest finishing time : HH MM AM PM ACCOUNT HOLDER DETAILSRELATIONSHIP*SelfMotherFatherFIRST NAME*LAST NAME*EMAIL* Booking confirmation and invoices will be sent to this emailMOBILE*POSTAL ADDRESS* Street Address Address Line 2 City State Post Code HOW DID YOU HEAR ABOUT US?*If you were recommended by a specific student or parent of MAPA, please specify in the "other" box.We'd love to send them a thank you card!GoogleFacebookInstagramWord of mouthRecommended by family or friendAgree to Terms & ConditionsStep 6: Agree to Terms & Conditions* I agree to MAPA's Terms & Conditions CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
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