The Chase A school of excellence MUSIC TUITION FEE FORM 2014/2015 Tuition Fee Form (please return to Mrs L Bridges, Cash Office) by 20th June 2014 Pupil……………………………………………………………………………………………… Form…………………………..Instrument…………………………………………………… Agreement As parent/guardian, I give my permission for the child who I represent to receive music lessons at The Chase School I understand that any FEES ARE REQUIRED IN ADVANCE of music tuition lessons. If fees are not received by the requested dates, lessons will be stopped and half a term’s fees will be charged. I understand that in the event of withdrawal from music tuition, HALF A TERM’S NOTICE MUST BE GIVEN IN WRITING to the Finance Office. Failure to give the correct written notice will mean that the next term’s fees become payable. Children in receipt of Free School Meals If your child receives free school meals, you should be eligible to receive a subsidy of £40 per term from Worcester Youth Music (WYM) and a school subsidy of 50%. Please attach your WYM subsidy application (on WYM website or contact the finance office for a copy) together with your application for school subsidy (see the Student Financial Support Policy available on the school website or by contacting the school).* This will mean the fees would reduce to £22.50 per term (group lessons) or £50.00 per term (individual lessons) Should your status change and you are no longer eligible for free school meals, then these subsidies will cease. I have read and agree to the terms as set out above and in The Chase Instrumental and Vocal Music Tuition Information for Parents leaflet. Parent/Guardian’s Signature……………………………………………………………………… Date…………………………… Please complete payment options on the following page 1 of 2 Group Tuition Fees (please tick relevant box) □ I will pay £125 for the Autumn Term via Parent Pay by 1st September 2014 and will pay for the other 2 terms via this method by 1st January 2015 and 1st April 2015 □ I enclose 3 cheques of £125 dated 1st Sept 2014; 1st January 2015 and 1st April 2015 made payable to The Chase School □ FSM applications and fees (see page 1*) □ I will pay £375 via Parent Pay by 1St September 2014 □ I enclose £375 cheque payable to The Chase School dated 1St September 2014 _____________________________________________________________________________ Individual Tuition Fees □ I will pay £180 for the Autumn Term by 1st September 2014 via Parent Pay and will pay for the other 2 terms via this method by 1st January 2015 and by 1st April 2015. □ I enclose 3 cheques of £180 dated 1st Sept, 2014; 1st January 2015 and 1st April 2015 made payable to The Chase School □ FSM applications and fees (see page 1*) □ I will pay £540 via Parent Pay by 1St September 2014 □ I enclose £540 cheque payable to The Chase School dated 1St September 2014 _____________________________________________________________________________ Instrument Hire (please tick relevant box) School Instruments (saxophones and trumpets only) □ I will pay £30 via ParentPay by 1st September □ I will pay £10 for the Autumn Term via ParentPay by 1st September 2014 and will pay for the other 2 terms via this method by 1st January 2015 and 1st April 2015 □ I enclose £30 cheque payable to The Chase School dated 1st Sept 2014 □ I enclose 3 cheques of £10 dated 1st Sept 2014; 1st January 2015 and 1st April 2015 made payable to The Chase School Other instruments: □ I wish to hire an instrument from WYM and understand that they will invoice me for the appropriate cost. 2 of 2