Registration form: Integrated Flautist UK with

Roderick Seed and Emma Shubin

Event Timing: Saturday 27th July 2019 11-3pm
Event Address: All Flutes Plus Warren Room, 60-61 Warren Street, London
Contact us at roderick.seed@gmail.com www.roderickseedflute.com www.integralsteps.org

*Required

1. Email address *

2. Name *

3. Telephone Number *

4. Are you a student (school, college, university)? *

Tick all that apply.

Yes
No

5. What would you like to work on? (Technique, repertoire, posture, etc) *

6. Approximate level on the flute *

Mark only one oval.

1 2 3 4 5

Beginner Advanced

7. Have you ever had a class in Dalcroze Eurhythmics?

Mark only one oval.

Yes, many
No, never
One or two

Other:
 8. I understand that I will have to pay £40 (or £25 if student) to register for this event. *
Tick all that apply.

Yes

Invoice

Upon receipt of your application, Roderick will send out an invoice to the email address you have
supplied above. To secure your space, it is recommended to pay in advance.

If you prefer to register by post, please send a cheque for the registration fee £40 (or £25 for students)
made payable to "Roderick Seed" and send with the application form to Roderick Seed, Horns
Cottage, Hoe Lane, Flansham, Bognor Regis, West Sussex PO22 8NT

Send me a copy of my responses.

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