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Mirra Fine Arts Pte Ltd

SINGAPORE
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Online Course Enrollment Form

* Select course :* Mandatory
Keyboard Acoustic Guitar Classical Guitar Flamenco Guitar
12 String Guitar Electric Guitar Bass Guitar

* Name:
(As in NRIC/BC)
* NRIC/BC:
* Date of Birth:  
Occupation:
Name of Parent / Spouse / Guardian:
* Address:


*  Singapore: 
* E-Mail:
* Phone:  (Home)     (Office)
 (Mobile)   (Pager)
Note: If applicant is below 17 years, the parent /spouse / guardian should fill in this form.
Are you sure you want to register for the selected course(s)?

    

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Level:                              Fees: $                              Day:                              Time:

 

 

Contact:   Radha Vijayan, Mirra Fine Arts Pte Ltd, BLK 130, Jurong East St 13, #04-231, Singapore 600 130.  Ph: (65) 6334 5283 Fax: (65) 6338 7576
E-Mail: mother21@singnet.com.sg  HP: 9780 5015

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