EIO Sign-Ups

1

Name (Nombre y Appelido)* This field is required.

First Name

Last Name

2

Pronouns (she/her, he/him, they/them, etc.)

3

Email* This field is required.

example@example.com

4

Phone Number (Número de Telefóno)* This field is required.

Please enter a valid phone number.

5

Date of Birth (Fecha de Nacimiento)* This field is required.

Date

6

Please select your instrument.* This field is required.

7

Years Played (Ańos Que Lleva Tocando)* This field is required.

Less than 3 years (Menos de 3 ańos)

3-5 years (3-5 ańos)

5-10 years (5-10 ańos)

10+ years (10+ ańos)

8

Ability to Sight Read Music (Lectura Musical a Primer Vista)* This field is required.

I can't sight read, but can play by ear (No puedo leer a primer vista, pero puedo tocar de oído)

Fair (Justa)

Very Good (Muy Buena)

9

How did you hear about us? (¿Cómo se enteró de nosotros?)* This field is required.

10

Notice of Filming and Photography* This field is required.By joining the Eisner Intergenerational Ensembles, you consent to be photographed, filmed, and/or otherwise recorded and to the release, publication, exhibition, or reproduction of any and all recorded media of your appearance, voice, and name in connection with Heart of Los Angeles and its initiatives.

I understand and consent

11

Are you interested in joining our carpool program?* This field is required. Are you open to riding with others to some or all events/rehearsals or providing transportation to some or all events/rehearsals?

YESNO

12

If you answered yes to the previous question, what area do you live in?