New Member To apply, please take the following steps: Click to read the COVID compliance agreement carefullyComplete the application form belowRemember to pay to secure your place Application Form (New Member) Please complete the form to request a place in CMA's covid-secure activities. * Indicates a required field. Student DetailsFirst Name * Family Name * Gender *MaleFemale Date of Birth Day *12345678910111213141516171819202122232425262728293031 Month *JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year *2002200320042005200620072008200920102011201220132014201520162017 Ethnicity Optional- to ensure fairness to all our members irrespective of ethnicity.Black African/ Black Caribbean/ Black BritishAsian/ Asian BritishMixed EthnicitiesWhite Other School Attended * School Year Group (2020/21) *Please select:Pre-schoolReceptionYear 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13n/a Medical Conditions Special Educational Needs Instruments Played1st Instrument / Voice * Grade Achieved *None TakenGrade1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8Diploma Add another instrument Add 2nd Instrument2nd Instrument / Voice * Grade Achieved *None TakenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8Diploma Add another instrument Add 3rd Instrument3rd Instrument / Voice * Grade Achieved *None TakenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8Diploma Add another instrument Add 4th Instrument4th Instrument / Voice * Grade Achieved *None TakenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8Diploma Parent / Guardian detailsTitle *MrMrsMissMsDr First Name * Family Name * Relationship to student * First line of address * Town * Post Code *Please use a single space Home Telephone *please include an STD code beginning with 0 Mobile Telephone *beginning with a 0 Email * Please select the groups which you would like to joinReception-Year 2 Reception and Year 1 Micro and Mini-Springers attend one session per week at the reduced Mini-Membership fee of £30 for half a term. Year 2 Springers classes include recorder, normal membership fees of £40 per half-term apply. Springers Programme Reception: Micro-SpringersYear 1: Mini-SpringersYear 2: Springers Older singers and instrumentalists A full range of graded ensembles is operational. We hope to offer two groups to each member if desired. Please indicate your choices here and we will try to accommodate your requests. Normal membership fees of £40 per half-term apply. First choice Please give your first choice of ensemble hereOrchestraWind BandJazz BandChoir Second choice Please give your second choice of ensemble hereOrchestraWind BandJazz BandChoirNone of the above (only one group required) Third choice Please give your third choice of ensemble hereOrchestraWind BandJazz BandChoirNone of the above (only one group required) Other informationHow did you hear about CMA? *Did you or your child:Receive a newsletter from schoolAttend a Sing, Perform, Inspire! workshopCome to the Big Noise!Attend a Springers PartyReceive a golden ticketSee a CMA concert at schoolHear about CMA from a friendSee an advert or posterOther Does anyone else in your family make music? Commitment *On behalf of the student, I am applying to Chiltern Music Academy for the activities stated. I agree to pay membership fees in advance.I agree to the above commitment. COVID policy *I have read and understand CMA's COVID compliance agreement. My child and I agree to observe the requirements.We agree Publicity *From time to time, we may take photographs or videos of students to provide material for marketing and training purposes. Images may be used for a range of printed media such as posters, flyers or brochures, as well as social media, for example CMA’s Website and Facebook page. We will not publish students' names without parental consent.I understand CMAs publicity policy. Data Protection We are collecting this information from you to help CMA manage your membership and activities with the organisation. We will not use it for anything else unless you say we can. You can find out more about how we store and use your data and what your rights are in our privacy notice. Thank you for your application. VerificationPlease enter any two digits *e.g. 12This box is for spam protection - please leave it blank