YESHUA BETH HALLEL MINISTRIES
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HMS Student Form
Hallel Music School Student Application Form
1. Personal Information
Full Name
*
0/100
Date of Birth
*
Clear
Gender
*
Select your gender
Male
Female
Prefer not to say
Address
*
0/200
City / State / ZIP
*
0/100
Phone Number
*
0/10
India (+91)
United States (+1)
United Kingdom (+44)
Australia (+61)
Germany (+49)
France (+33)
Japan (+81)
Russia (+7)
China (+86)
Brazil (+55)
South Africa (+27)
Pakistan (+92)
UAE (+971)
Nigeria (+234)
Email ID
*
0/100
Parent / Guardian Name (if under 18)
0/100
Parent / Guardian Contact
0/15
2. Course Information
Program Applying For
*
Beginner
Intermediate
Advanced
Instrument / Specialization
*
Piano
Guitar
Violin
Drums
Vocal
Other:
Preferred Class Type
*
Individual
Group
Online
In-Person
Preferred Schedule
*
Weekdays
Weekends
Morning
Evening
3. Course Type / Certification Options
*
Please select the type of course you want to enroll in:
I want to learn Free Basic Music
I want to learn Professional Music with HMS Certificate (Paid)
I want to learn Professional Music with LCM Certificate (Paid)
4. Music Background (if any)
Years of Experience
Previous Training / School
0/200
Music Exam Certifications (if any)
0/200
Performance Experience
School events
Competitions
Choir
Other:
5. Goals & Interests
What do you hope to achieve by joining our music program?
0/1000
6. Volunteer Opportunity
Would you like to be a volunteer for school events, concerts, or workshops?
Yes
No
7. Emergency Contact
Name
*
0/100
Relationship
*
6/50
Parent
Spouse
Child
Sibling
Other
Contact Number
*
0/15
8. Referral Information
How did you hear about us?
*
Select an option
Facebook
Instagram
YouTube
TV Program
Friend or Family
Event or Conference
Flyer or Poster
YBH Website
Other (Please specify)
Submit Application
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