Referral Form - Individual Lessons - Victoria Conservatory of Music

Contact Information

Requested Start Date

Student's Name*

First Last

Date of Birth

Phone*

Email*

Parent/Guardian/Payer Name (if different from student)

First Last

Phone (if different from student)

Email (if different from student)

Preferred Contact Method

Phone
Email

Musical Interest Information

Which instrument(s) are you interested in studying?*

What is your FIRST CHOICE (if more than one instrument is listed)?

Please indicate the musical style you would prefer to study, if known

Classical music
Contemporary genres (jazz/folk/pop/musical theatre)
No preference/don’t know

Name of preferred instructor(s) (if known)

Previous instructor(s) (if applicable)

What is your past musical experience?

Briefly describe your musical goals

Which location would you prefer?*

Downtown Victoria (900 Johnson Street)
Westhills, Langford (210 - 1314 Lakepoint Way)
Either

I would like to have online lessons

Please note the location is still required even if online lessons are preferred.

Availability

Please indicate the DAYS and TIME RANGES that will work best for you for scheduling lessons (up to 4, or enter more detailed information below) NOTE: Downtown and Westhills locations have different hours of operation, please see vcm.bc.ca/contact for full list

Availability (1 of 4)*

Availability (2 of 4)*

Availability (3 of 4)

Availability (4 of 4)

ADDITIONAL INFORMATION (use this space to supply any further details that may assist us in assigning the instructor that will suit you best)

Pricing Information

TUITION: Lessons are available at four Fee Levels, depending on the experience of the instructor and the proficiency level of the student. Rates are $53, $63, $73 and $83 per hour, pro-rated for shorter lesson times. The VCM cannot guarantee the fulfillment of requests for specific Fee Levels, but will endeavor to match the student to faculty that represents the best possible fit for a musical education. For more information about fees, payment methods, refunds and withdrawals, please visit vcm.bc.ca/students/tuition-fees-and-payment-info

Please indicate any financial restrictions for appropriate placement

How did you find this form?

Found through VCM website search
Directed to form by VCM staff

Referral Form – Individual Lessons

Student Referral Form

Contact Information

Musical Interest Information

Availability

Pricing Information