Nutcracker School Outreach: Requests for Free Tickets
DUE: Friday, October 28, 2022 by 5:00 pm (Pacific)
Contact Information
Teacher's Name
*
First Name
Last Name
Email Address (school affiliation)
*
example@example.com
School Phone Number, include extension
*
Cell Phone Number
*
Please enter a valid phone number.
School Profile
School Name
*
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School District Affiliation
*
Alvord USD
Corona Norco USD
Jurupa USD
Moreno Valley USD
Murrieta USD
Perris Union High SD
Riverside USD
Val Verde USD
Other
OTHER: If your school district was not listed, please indicate your school district affiliation
Is this a Title 1 School
*
Yes
No
Class Profile
Grade Level
*
Primary Elementary School (K-3)
Upper Elementary School (4-5)
Middle School (6-8)
High School (9-12)
Number of chaperone(s) including teacher of record [ RATIO: 1 to 15]
*
Number of female students
*
Number of male students
*
Performance Selections
1st Preference for Show Date & Time
*
Please Select
Tues, Nov 29, 2022: 10:00-10:45 am
Tues, Nov 29, 2022: 11:15 am-12:00 pm
Wed, Nov 30, 2022: 10:00-10:45 am
Wed, Nov 30, 2022: 11:15-12:00 pm
Thurs, Dec 1, 2022: 10:00-10:45 am
Thurs, Dec 1, 2022: 11:45 am-12:00 pm
Fri, Dec 2, 2022: 10:00-10:45 am
Fri, Dec 2, 2022: 11:45 am-12:00 pm
2nd Preference for Show Date & Time
*
Please Select
Tues, Nov 29, 2022: 10:00-10:45 am
Tues, Nov 29, 2022: 11:15 am-12:00 pm
Wed, Nov 30, 2022: 10:00-10:45 am
Wed, Nov 30, 2022: 11:15-12:00 pm
Thurs, Dec 1, 2022: 10:00-10:45 am
Thurs, Dec 1, 2022: 11:45 am-12:00 pm
Fri, Dec 2, 2022: 10:00-10:45 am
Fri, Dec 2, 2022: 11:45 am-12:00 pm
No Selection
3rd Preference for Show Date & Time
*
Please Select
Tues, Nov 29, 2022: 10:00-10:45 am
Tues, Nov 29, 2022: 11:15 am-12:00 pm
Wed, Nov 30, 2022: 10:00-10:45 am
Wed, Nov 30, 2022: 11:15-12:00 pm
Thurs, Dec 1, 2022: 10:00-10:45 am
Thurs, Dec 1, 2022: 11:45 am-12:00 pm
Fri, Dec 2, 2022: 10:00-10:45 am
Fri, Dec 2, 2022: 11:45 am-12:00 pm
No Selection
With this submission, I understand and agree transportation arrangements and costs will NOT be covered by BRAVA.
Signature
*
Date
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Submit
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