Tianjin Juilliard Consultative Lesson Request Form | 天津茱莉亚咨询课申请表

Student Information

*First (Given) Name | 名 (拼音)：

*Last (Family) Name | 姓 (拼音）：

Chinese Name (If Applicable) | 中文名

*Birthdate | 出生日期：

*Email Address | 电子邮件地址：

*Mobile Phone Number | 手机号码：

By supplying my mobile phone number above, I agree Tianjin Juilliard may contact me via SMS and MMS messaging up to 4 times a month. Examples of messages include, but are not limited to, reminders and school information. To opt-out, reply STOP to any message. Message and data rates may apply.

*Country of Residence | 所在国家：

*Province/Region/State | 省/地区/州

*Primary Citizenship | 国籍：

Program Information

I am interested in | 我想关注：

*Intended Major | 专业:

Collaborative Piano

Instrumental and Chamber Music Studies

Instrumental and Orchestral Studies

*Instrument | 乐器：

Consultative Lesson Information

*Which teacher would you like to take a lesson with? | 您想与哪位老师上咨询课?

You can find a complete list of our faculty bios here.
请点击此处查看完整教师名单。

You are required to provide a video link of yourself playing or a link to your composition work for the faculty to review.
您需要提交一段自己的近期演奏视频或作曲作品供老师审阅。

*Please provide us a link to a video of your recent playing.
请将演奏视频或其他材料上传至门户网站并将链接填写在下方。

*Please give us a brief introduction of yourself which should include basic information about your music study.
请提交一段自我介绍，内容可以包含您的基本信息、学习音乐的情况等。

If approved, how would you like to take the lesson?
如申请通过，您希望以何种形式上课？

Please give us three dates and times which would work for you and if you are approved to take a consultative lesson, we will do our best to accommodate your availability.
请在下方选择三个可以上课的时间段。如果您的申请通过，我们将尽量帮助您协调安排课程时间。

*Preferred Date｜首选日期

*Please choose your preferred time period on this date. All times are China Standard Time.
请选择此日期中您希望上的课时间段（中国标准时间）。

9:00am-12pm

12:00pm-2:00pm

2:00pm-4:00pm

4:00pm-6:00pm

*Second Preferred Date | 其他日期

*Please choose your preferred time period on this date. All times are China Standard Time.
请选择此日期中您希望上的课时间段（中国标准时间）。

9:00am-12pm

12:00pm-2:00pm

2:00pm-4:00pm

4:00pm-6:00pm

*Third Preferred Date | 其他日期

*Please choose your preferred time period on this date. All times are China Standard Time.
请选择此日期中您希望上的课时间段（中国标准时间）。

9:00am-12pm

12:00pm-2:00pm

2:00pm-4:00pm

4:00pm-6:00pm

If you have other availability, you can list it here.
如果您有其他可以上课的时间，请在下方列出。

Information Collection

Tianjin Juilliard School Personal Information Collection Statement | 天津茱莉亚学院个人信息收集声明：

*I have carefully read the Tianjin Juilliard School ("TJS") Privacy Policy, which can be found here, and I hereby consent, for myself and on behalf of any minors under my guardianship whose personal information I have provided, to TJS to have my personal information or personal information of the minor under my guardianship collected, processed and transferred to locations within or outside of my jurisdiction in accordance with the TJS Privacy Policy.

我已仔细阅读天津茱莉亚学院（“天津茱莉亚”）的《隐私政策》，您可通过点击此处阅读并了解政策的具体内容。我在此代表本人及本人提供的个人信息所涉及的任何其他在本人监护下的未成年人同意天津茱莉亚根据其《隐私政策》收集、处理并转移本人或本人监护下的未成年人的个人信息至我所在的司法管辖区外的地点。

Please check the box below:

Yes

*I wish to receive marketing and other communications, including information about TJS programs, services, events, and products etc. as described in the TJS Privacy Policy through channels that I have given my personal data.

我希望通过我提供个人信息的渠道，接收天津茱莉亚《隐私政策》中所述的营销信息和其他信息，包括天津茱莉亚的项目、服务、活动和产品等信息。

Please check the box below:

Yes