Ambassador Application Form

For the purposes of filling out this application, "you" refers to the student.
Date of Submission*

MonthDayYear
Date
If you have not read the Ambassador program rules for the new season, you can review them in a new tab by clicking below:

View Rules
I have read the Ambassador program rules.*

YesNo
Student First Name*
Student Last Name*
Parent/Guardian First Name*
Parent/Guardian Last Name*
Parent/Guardian Cell Phone*
Please enter a valid phone number.
Please enter the Grade Level you will enter in Fall 2024.*

FreshmanSophomoreJuniorSenior
Name of the high school you are attending in Fall 2024?*
Are you attending the same school as last year?*

YesNo
Student Email*
example@example.com
Student Cell Phone*
Please enter a valid phone number.
T-Shirt Size*
All sizes listed are ADULT sizes.
Are you a member of The Jackson Symphony Youth Orchestra?*

YesNo
Are you a member of a high school band?*

YesNo
Do you play any instruments?*

YesNo
If yes, what do you play?
Are you interested in live orchestral music?*

YesNo
Have you attended a Jackson Symphony concert?*

YesNo
Please list all sports, theatre, dance, or church activities in which you currently participate.*
Please list all current volunteer activities in which you participate.*
Do you currently have a family member in the program?*

YesNo
If yes:
Family Member's Name
Relationship To You
If there are any other students in your family who would like to apply for the Ambassador program, please return here after your parent has completed the Parental Consent form and fill out another application.
Upon clicking 'Submit,' you will be taken to the Parental Consent form which your parent MUST complete for your application to be accepted.
Should be Empty:

For the purposes of filling out this application, "you" refers to the student.

If there are any other students in your family who would like to apply for the Ambassador program, please return here after your parent has completed the Parental Consent form and fill out another application.

Upon clicking 'Submit,' you will be taken to the Parental Consent form which your parent MUST complete for your application to be accepted.