THEORY BY EMAIL

ENROLMENT FORM

To enrol for 'Theory by Email' please complete the form below, then click the 'ENROL FOR COURSE' button once only. A confirmation page will appear, and you will need to pay for your first module by following the instructions given.

PART ONE -- YOUR DETAILS
YOUR FULL NAME (Please include your title -- Mr, Mrs, Miss, Ms or other):

YOUR FULL POSTAL ADDRESS:



YOUR COUNTRY:

YOUR POST/ZIP CODE:
 YOUR EMAIL ADDRESS (eg. you@aol.com):

YOUR TELEPHONE NUMBER
(Optional; please include the area code):

YOUR FAX NUMBER
(Optional; please include area code):
PART TWO -- YOUR MUSICAL DETAILS
WHERE WOULD YOU LIKE TO START THE COURSE?
The beginning
Grade 2
Grade 3
Grade 4
Grade 5
PLEASE NOTE: Commencing the course at the beginning is recommended unless you have passed a theory exam up to at least Grade 3 level.		 HAVE YOU STUDIED MUSIC THEORY IN THE PAST?
Yes
No
If yes, please give the grade(s) you have studied.
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
HAVE YOU PASSED ANY THEORY OF MUSIC EXAMS IN THE PAST?
If so, please indicate which grade(s):
Grade 1
Grade 2
Grade 3
Grade 4
Name of board whose exam(s) you passed (eg. Associated Board):

Approximately which year was this?
 WHY WOULD YOU LIKE TO STUDY MUSIC THEORY?
Please give your main reason(s):

Do you play a musical instrument?
Yes
No
If yes, which instrument do you play?
PART THREE -- YOUR COMPUTER DETAILS
WHAT OPERATING SYSTEM DO YOU HAVE ON YOUR COMPUTER? (eg. Windows 2000):
 WHAT SIZE IS YOUR HARD DRIVE? (eg. 20Gb):
WHAT EMAIL SYSTEM DO YOU HAVE? (eg. Outlook Express):

Are you able to send emails with attachments?
Yes        No

WHAT BROWSER DO YOU HAVE?
(eg. Internet Explorer)
 FINALLY...
Check each part of the form carefully, then click on the ENROL FOR COURSE button below. PLEASE NOTE: In order to enrol for the course and receive your first module you MUST follow up this form with a valid credit card payment; otherwise your details will be ignored.

PRIVACY STATEMENT

Information collected by DP Music Services will be used only for the operation of the online correspondence course 'Theory by Email' or the postal correspondence course 'Theory by Post' and for internal marketing and statistical purposes. Under no circumstances will any student's details be passed on to a third party.

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