Individual Registration

Please enter information in the form below to process registration for event Annual Membership - Student.

First Name *

Last Name *

Organization

Address *

Province *

City *

Postal Code *

Country *

Phone *

Email *

Profession *

Dalcroze Experience *

To receive important emails regarding Dalcroze courses, workshops and updates, we need your consent to communicate. I agree to receive electronic communications about Dalcroze Canada's programs and services including class changes, student communications, and future program offerings and/or updates. I understand that I can withdraw my consent at any time.

Your email address is confidential and will never be shared with third-parties.

Email Consent *

Comment

Payment Information

Amount

Payment Method

Paypal

Billing Zipcode*

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*

Verification code*

We are now accepting 2019 Membership Registrations!

All memberships run for the calendar year January 1 to December 31 of the same year.

Individual Registration

Payment Information

We are now accepting 2019 Membership Registrations!

All memberships run for the calendar year January 1 to December 31 of the same year.

Individual Registration

Payment Information

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