Adult Enrolment Form Personal Information First Name* Surname* Address Line 1* Address Line 2 Town* Post Code* Email Address* Phone Number (with no spaces)* Further Information Age Group 16-25 26-39 40-65 Over 65 Employment Status Student Employed Unemployed Retired Other Do you have any special needs?* Yes No If Yes please provide further information:-: Emergency Contact Name* Emergency Contact Phone (with no spaces)* Class Enrolment Term* T3 Feb-Mar 2019 T4 Apr-Jun 2019 T1 Aug-Oct 2019 T2 Oct-Dec 2019 Monday Classes Monday Class None ACC Accordion BJT Tenor Banjo B5M 5-String Banjo BOR Bodhran CEL Cello GTR Guitar MAN Mandolin UKE Ukulele WHI Whistle Monday Payment None £70 Adult Class 1 £54 Concession 1 £7 Member Only £140 Term 1+2 Aug-Dec £140 Term 3+4 Feb-Jun £108 Term 1+2 Conc Aug-Dec £108 Term 3+4 Conc Feb-Jun Level / Tutor (if known) Wednesday Classes If taking classes on both Monday and Wednesday, please select Class 2 payment for Wednesday Wednesday Class None ACW Accordion BJ5 5-String Banjo CBD Ceilidh Band FDL Fiddle GTW Guitar HAR Harmonica MXW Mixed Instrument Wednesday Payment None £70 Adult Class 1 £63 Adult Class 2 £54 Concession 1 £48 Concession 2 £7 Member Only £140 Term 1+2 Aug-Dec £140 Term 3+4 Feb-Jun £108 Term 1+2 Conc Aug-Dec £108 Term 3+4 Conc Feb-Jun Level / Tutor (if known) Payment Details - Online Enrolment Completing this Online Enrolment will send an email to you and GFW with a GFW ID at the top of the email. Online Banking - transfer payment to: Glasgow Fiddle Workshop, A/C No: 10000769 Sort Code: 80 11 80. Please use your GFW ID as payment reference. e.g. GFW ID 123 Cheque by Post – Write your GFW ID number on back of Cheque and post to: GFW, Glasgow Kelvin College East End Campus, John Wheatley Building, 2 Haghill Road, Dennistoun, Glasgow G31 3SR. Cash or Cheque – Take note of your GFW ID and bring cash or cheque to John Wheatley Building on enrolment night Select Payment Method* Online Banking Cheque Cash Gift Aid For every £1 donated, GFW can claim an extra 25 pence if you are a basic rate tax-payer. Tax paid includes tax paid on pensions, State pension, savings and Capital Gains Tax. To claim this refund GFW will send your name and address on a claim form to HMRC. I am a tax payer in the UK and I would like GFW to reclaim the tax, through Gift Aid, on donations I make from today until I notify you otherwise. I currently pay UK income and/or Capital Gains tax, equal to or greater than GFW will claim from HMRC in the year/s I donate.* Yes No Permissions I acknowledge GFW will not share my details with any third party, unless required by GDPR. GFW may use my email to inform me of GFW activities and events, and of similar events which GFW students may find useful to their learning and enjoyment. For more details see Privacy Policy* Volunteering I would be interested in helping GFW by Volunteering:* Yes No If Yes areas I may be able to help in are:- next Please ensure all information is correct before pressing the submit button. Personal Information First Name Surname Address Line 1 Address Line 2 Town Post Code Email Address Phone Number Age Group Employment Status Do you have any special needs? Special Needs Information Emergency Contact Name Emergency Contact Phone Class Enrolment Term Monday Class Monday Payment Monday Class Level Wednesday Class Wednesday Payment Wednesday Class Level Payment Method Gift Aid Gift Aid Permissions Sole GDPR and use of personal information by GFW Volunteering Volunteering Volunteering Areas Please complete the security check by ticking the "I 'm not a robot" box back submit Thank you for enrolling with GFW. Confirmation will be sent to your email, which includes a GFW ID for payment reference. Please turn on javascript to submit your data. Thank you! Powered by BreezingForms