Academy of Music Intent to Register Form

Please fill out this form to reserve your place in the Academy program. If you do not complete this form, your place in the Academy can not be guaranteed.

Please fill out this form if and only if:

1. You have completed an Academy application form and you have done an Academy audition.
2. You have received your official acceptance letter into the Academy.

First name:
Last name:
Date of birth: (YYYY/MM/DD)	//
Age:
Street address:
City:
Province:
Postal Code:
Phone number: (including area code)
Cell number: (including area code)
E-mail
Parent Contact: (First and last name)
Instrument:	Instrument Bassoon Clarinet Cello Dbl Bass English Horn Flute French Horn Guitar Oboe Piano Trumpet Trombone Sax Viola Violin Voice
Academy level:	Level Junior Junior/Intermediate Intermediate Intermediate/Associate Senior Associate Participant
Large Ensemble: (if you know you have been accepted)	Ensemble Calgary Youth Orchestra Chamber Strings Conservatory Strings Intermediate Strings Junior Strings Pre-chamber A Pre-chamber B Prepatory Strings U of C Jazz Ensemble U of C Wind Ensemble U of C Lab Band Other (May require Academy Manager approval)
Current Level of Theory:	Current Level RCM Preliminary Rudiments RCM Rudiments 1 RCM Rudiments 2 RCM Harmony 3 Other - higher than Harmony 3 Other - lower than Preliminary Rudiments Other class based theory - level not known No theory taken at all
Theory Class I am Interested In:	Class of Interest I would like to enrol in an RCM based theory class I will take whatever theory class is offered to me through Academy
Private teacher's first name:
Private teacher's last name:
Private teacher's e-mail:
Private teacher's phone number:

Payment for Academy can be made by calling 403.440.6821, or in person at the Conservatory office. You can pay by cash, cheque, credit card, or the payment plan. A description of the payment plan can be found here.