MYC® Level One

Registration Form
for Canada

STUDENT'S NAME MYC LEVEL SUNBEAM 1

BIRTHDATE DAY/TIME of CLASS /
SCHOOL CHILD ATTENDS GRADE IN SCHOOL (if applicable)
PARENT'S NAME
ADDRESS
Street/RR# City/Town

Province Postal Code

PHONE (Home) (Work) (Cell)

EMAIL __________________________________INSTRUMENT AT HOME

Student information is for use only by Music for Young Children.
It will not be passed or sold to a third party without your written consent.
HOW DID YOU HEAR ABOUT MYC?
( ) brochure ( ) word of mouth ( ) yellow pages ( ) newspaper ad ( ) website
( ) other (please specify)
IS THERE ANYTHING SPECIAL THAT WE SHOULD KNOW ABOUT YOUR CHILD?

Sum mary: Level Technique Tool Box ( ), Songs CD ( ), MIDI Disks ( ), Accomp.CD ( )
MB1 Stickers ( )

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Music for Young Children® Student Registration Receipt
MYC Student Materials $162.64 Name
MYC Technique Tool Box* $12,38 MYC Level SUNBEAM 1
MYC Songs CDs* $6.72 Day/Time of class
MYC Accompaniment MIDI*
MYC Accompaniment CD*
MYC Music Stickers (MB1)* * optional supplies
Handling Fee
Classroom Supplies & Fees Additional supplies are available at the
GST MYC Shopping Cart www.myc.com
PST **
TO TAL $181.74
** PST applies in NS, NB, NL, PQ and ON on all supplies except bound books
TEACHER'S NAME Tracey Robinson Phone 613-498-3141 Email lynmyc@cogeco.ca

COORDINATOR'S NAME Wendy Knapp Phone 613-832-3038 Email w.knapp@myc.com

SS1_Registration.doc