This form should be completed by schools only

These individual/small group lessons will be charged to the school and take place at the pupil's school.  This form must be completed by a member of school staff who has the authority to make the application on behalf of the school and its pupil(s).

If your school would like to enquire about large group or whole class tuition, music clubs or workshops, please email instead of completing this form.

Information about lessons and prices >

Pupil details
Please choose the instrument your pupil wishes to learn
Loans are subject to availability. A one-off £20 fee will be payable and an Instrument Loan Agreement must be completed on issue of the instrument. School will be responsible for the instrument including for the return at the end of the loan period and the cost of any servicing, repairs or replacement due to loss, damage or wear and tear to the instrument or associated loaned equipment.
Please select your preferred lesson type
Please note: Prices are valid for the current year and are subject to annual review. If a suitable group is not available, pupils will receive shorter individual lessons (Option A 10 mins, Option B 15 mins).
School liasion information

Please give detail for the school liaison for day-to-day lesson support (e.g. a DSL, support worker, head of music or class teacher)

School billing contact

Please give details for the contact for invoicing and billing - this must be a member of school staff (not a parent/carer)

Funding sources
This information will be used to determine whether the pupil may be entitled to continuous funded tuition should they move school within Kirklees. If lessons are not funded by the Kirklees Virtual School, lessons will automatically be cancelled once the pupil completes their final year group at their current school.
Any other information
I understand that lessons will continue term on term and year on year. I agree to advise Musica Kirklees office in writing by the date specified within the Terms and Conditions should I wish for lessons to discontinue at the end of a term. I have obtained permission from the parent/carer and pupil to share the information given on this application with Musica Kirklees.