FLUTES AT DAWN PROGRAM
Please complete the section of the form that applies to you:. Section I. All complete, Section II. Individuals, Section III. Schools & Organizations and Section IV. Volunteers. Thank you very much!
SECTION I - ALL APPLICANTS -Please complete
Please complete Section I
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
If under 18 yrs, please provide Parent or Guardian information:
Parent/Guardian Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
SECTION II. INDIVIDUAL REGISTRATION
Please complete the information in section II Below:
Areas of interest:
Music Production (composing, beat-making, songwriting and recording)
Singing
Piano
Drums and Percussion
Video Production (music videos, documentaries, and short films, filming and editing)
Dance - Hip Hop, Latin, or Traditional West African
Other
What are your goals?
Tell us a little more about yourself:
SECTION III. SCHOOLS & ORGANIZATION REGISTRATION
Please complete the information in section III Below:
Name of School or Organization
Name of Main Contact Person
Phone Number of Main Contact Person
Please enter a valid phone number.
Format: (000) 000-0000.
Email of Main Contact Person
example@example.com
Age range of participants (select all that apply)
8 to 12 yrs
13 to 19 yrs
20 to 25 yrs
26 and UP
Number of Participants
Select all programs you are interested in bringing to your site:
Music Production (composing, beat-making, songwriting and recording)
Video Production (music videos, documentaries, and short films, filming and editing)
Dance - Hip Hop, Latin, or Traditional West African
Modern Masculinity - discussion groups for young men ages 10 to 25 (love and relationships, self-care, patriarchy, feminism, gender roles, toxicity)
Duration of Program:
One Day Pop-Up Workshop (3 hrs)
4 Week Program (2 hrs per week)
8 Week Program (3 hrs per week)
During which time of day would you like the program to occur? (select all that apply)
Morning (8a-11a)
Afternoon (1p-4p)
Evening (4-7p)
Tell us a bit about your students and your goals for them:
Additional Comments and/or Questions:
SECTION IV. VOLUNTEERS
Please complete the information in section IV Below:
Areas of Expertise (select all that apply)
Music Production
Songwriting
Performing
Dance
Video Production
Live Events
Social Media
Age range of people you’re interested in working with (select all that apply)
8 to 12 Yrs.
13 to 19 Yrs.
20 to 25 Yrs.
26 and Up
Which of the following are you interested in? (select all that apply)
Working in educational settings
Helping with live events
Speaking to groups
Providing resources for marketing and promotions
Misc logistics such as transportation and food service
Tell us a little more about yourself:
Please Submit & Thank You!
Should be Empty: