KoSA Italy Registration

You may also download the registration form here
or call us at 1-800-541-8401

If paying by check, please mail to:
KoSA Communications International
PO Box 333, Station St. Jacques
Montreal, QC H3C 2S1 Canada

Name*
First Middle Last
Age*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone*
Mobile*
(we may send you text messages)
- Yes
- No
Email*
Do you have a personal website?
If so, please enter it here:
Your instrument:
How many years have you been playing your instrument?
Program Pricing
- 290$ US
Product Name
Total
$ 0.00
Payment Method*
- Credit Card
- Cheque
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Currency
If paying by check, please mail to:
KoSA Communications International
PO Box 333, Station St. Jacques
Montreal, QC H3C 2S1 Canada
CAPTCHA

514-482-5554
Toll Free: 1-800-541-8401
[email protected]