2005-2006 Registration Form


Contact Information

First Name: ________________________†††† Address:___________________________

Last Name: ________________________ †††† City: _______________________________

Phone #: (____)_____________________†††† Postal Code: _________________________

Cell / Pager #: ______________________ Email _________________________________

Birth Date: for RCM Examination Purposes :___________________RCM Number________________

Piano Instruction Fee Schedule:

I†††† Jazz, Theory Composition†††††

q      45 Min $ 112.50 per month†† †††††††

** Plus $55.00 registration fee††††††††††† Classical Lesson Fees†††††

II†† Introductory- and Grade 1-2

q      30 Min††††††† $75.00/mo

**Plus $55.00 registration fee†††††

III Intermediate (RCM Grade 3-5)

q      60 Min††††††† $150.00/mo††††††

**Plus $55.00 registration fee††††

IV Advanced (RCM Grade 6-8)

q      75 Min††††††† $187.50/mo††††††

**Plus $55.00 registration fee†††† ††

V Master Classes RCM 9-ARCT

q      90 Min††††††††† $225.00

**Plus $55.00 registration fee

VI Jazz/Pop/Blues & Improvisation

q      60 Min $150.00

q      75 Min $187.50

q      90 Min $ 225.00

**plus $55.00 registration fee








Note:Choose one applicable checkbox from either the monthly payments section or the lump sum payment section


Cheques dated July 1, 05 and Feb1, 06

q      Semester 1$540

Semester 2$540††† Save $100

No registration fee required


q      Semester 1$380.00

Semester 2$380.00 Save $65

No registration fee required

q      Semester 1$710

Semester 2$710†† Save $135

No registration fee required

q      Semester 1$880

Semester 2$880††† Save $170

No registration fee required

q      Semester 1$1045

Semester 2$1045Save $215

No registration fee required

q      Per Semester 1&2 $710-save-$135

q      Per Semester 1&2 $880-save-$170

q      Per Semester 1&2 $1045-save-$215

No registration fee required

Additional savings if paid in full for year

Current Day/Time:

q      Monday††††† 1:00-9 pm

q      Tuesday†††† 1:00-9 pm

q      Wednesday 1:00-9 pm

q      Thursday††† 1:00-6 pm

Time ___:___PM

Please contact me if times donít work

Request New Time:

q      Monday††††††† 1:00-9 pm

q      Tuesday†††††† 1:00-9 pm

q      Wednesday†† 1:00-9 pm

q      Thursday††††† 1:00-6 pm

Time ___:___PM

Please contact me if times donít work

Some times and dates may have to be adjusted to facilitate current students extended lessons


Extra lessons charges

Classical Piano Theory $55 per hr.

Jazz instruction $55.00per hr.

Assessment and Adjudication Fees, $55.00 per hr

Copying of music and theory exams see note below

Please read the following carefully and sign the agreement. A copy will be given to you for your records. The lesson time has been reserved for you from September 12th 2005 to June 16th of 2006. No Lessons will be rescheduled for activities that interfere

with the applicantís lesson time including school functions eg. Vacations or Holidays outside of Christmas and Spring Break, Sports Events, Birthday Parties, Night School, Exchange Programs, Doctor and Dental appointment, missed lessons will not be made up. ††††††††††††

          No refunds will be issued for the above reasons-if instructor unable to make lesson full refund will be made.

          Give 24 hours notice to cancel a lesson.

          In case of illness, every effort will be made to do a make-up if openings come available week of missed lesson. Although there are no guarantees this will be done. Note Studio policies per missed lessons

          No lessons during Christmas and Spring Break

          Post Dated cheques required as per instructions

          Two months notice for permanent cancellation of Lessons

          Registration Fee is non-refundable-All Cheques Made out to TOSOFF MUSIC SERVICES

*Copying and Printing of Music and Theory Exams will be charged out at 25 cents a copy. Client will be invoiced accordingly.

*Registration Fee of $55.00 is Waived if Paid in Full before or on July 1st, 2005 only applies to Those who do lump sum year and Ĺ year payment Enclose a Post Dated Cheque dated July 1st 2005 and February 1, 2006, both cheques must accompany this form.All others must forward all 10 postdated cheques dated from Sept 01, 2005 to June 1 2006 and a $55.00 registration fee dated July 1st 2005, submit with completed registration form before June 1st, 2005, earlier registration suggested to guarantee lesson times

*Refunds on permanent cancellation will be made only in the event of long term illness or family emergency that affects

The ability of the student to perform their assignments, Doctors Certificates are required otherwise no refunds.

A two-month lead-time in the event of cancellation must be given for those who pay month to month and for those who paid lump sum payment less the original discount given.

*Applicants / Guardianís Signature: _____________________ †††††††† Date: _____________

*I have read and agree to the terms of this contract, This form must be signed & dated; tuition fees must accompany this form.


Tosoff Music Services††††††††††††††††††††††††††††††††††††††††††† Bryon Tosoff

15690 Buena Vista Ave.†††††††††††††††††††††††††††††††††††††† Piano and Theory Instructor

White Rock, BC V4B 1Z5†††††† †††††††††††††††††††††††††††††† ††RCM Piano - Theory - Harmony

Cell #:††† 785-5706 ††††††††††††††††††††††††††††††††††††††††††††† Jazz & Improvisational Techniques and Composition

Phone #: 531-9828††††††††††††††††††††††††††††††††††††††††††††† Rock, Pop, Blues Instruction

http://www.pianoteacher.ca/††††††††††††††††††††††††††††† btosoff@shaw.ca