Sarah McLachlan School of Music Online Registration

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Welcome to SoM! We exist to provide free music education, long term supportive mentorship and safe place to explore your creativity for youth in Vancouver, Edmonton and selected schools in Surrey who face socio-economic barriers to access. Please visit our website for more information on which schools are eligible. We look forward to receiving your application! Please note that we are not currently accepting applications for new students for our Surrey program.

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Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

Province*

Postal Code*

Home or Primary Phone*

Additional Info

Emergency Contact Info (Not Contact #1 or #2 below)*

We'll call you to talk about the application. Do you prefer a call in a language other than English?

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

School*

Grade Level*

Are you applying because of a Partner Program, Financial need, or Social-Emotional need?*

Please outline any learning or behavioural supports that the student may need in our programs?

Allergies/Dietary Restrictions*

Does the student have any medical conditions we should be aware of?

What languages are spoken at home?*

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

School*

Grade Level*

Are you applying because of a Partner Program, Financial need, or Social-Emotional need?*

Please outline any learning or behavioural supports that the student may need in our programs?

Allergies/Dietary Restrictions*

Does the student have any medical conditions we should be aware of?

What languages are spoken at home?*

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

School*

Grade Level*

Are you applying because of a Partner Program, Financial need, or Social-Emotional need?*

Please outline any learning or behavioural supports that the student may need in our programs?

Allergies/Dietary Restrictions*

Does the student have any medical conditions we should be aware of?

What languages are spoken at home?*

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

School*

Grade Level*

Are you applying because of a Partner Program, Financial need, or Social-Emotional need?*

Please outline any learning or behavioural supports that the student may need in our programs?

Allergies/Dietary Restrictions*

Does the student have any medical conditions we should be aware of?

What languages are spoken at home?*

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

School*

Grade Level*

Are you applying because of a Partner Program, Financial need, or Social-Emotional need?*

Please outline any learning or behavioural supports that the student may need in our programs?

Allergies/Dietary Restrictions*

Does the student have any medical conditions we should be aware of?

What languages are spoken at home?*

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Questions or Concerns

Comments

Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Student #2 (Show-Hide Details)

Additional Info

Student #3 (Show-Hide Details)

Additional Info

Student #4 (Show-Hide Details)

Additional Info

Student #5 (Show-Hide Details)

Additional Info

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

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