EIO Sign-Ups

1

Name (Nombre y Appelido)

First Name

Last Name

2

Email

example@example.com

3

Phone Number (Número de Telefóno)

Please enter a valid phone number.

4

Date of Birth (Fecha de Nacimiento)

Date

5

Please select your instrument.

6

Years Played (Ańos Que Lleva Tocando)

Less than 3 years (Menos de 3 ańos)

3-5 years (3-5 ańos)

5-10 years (5-10 ańos)

10+ years (10+ ańos)

7

Ability to Sight Read Music (Lectura Musical a Primer Vista)

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)

8

How did you hear about us? (¿Cómo se enteró de nosotros?)

9

Type a question

Fully vaccinated, at least 2 shots (Totalmente vacunado, al menos 2 dosis)

Partially vaccinated, at least 1 shot (Parcialmente vacunado, al menos 1 dosis)

Not vaccinated (No vacunado)

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