Middle/High/ Home School Enrollment Form
!!Join A Place Of Home, Guidance, And Fun!!
Student Information
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Gender
Male
Female
Grade
Please Select
6th
7th
8th
9th
10th
11th
12th
2023-2024 Season
Experience in Band?
Please Select
Yes
No
It's Been A While (2 grades Ago or More)
We'll teach you regardless. No Experience Required
Instrument
Please Select
No Experience
Flute
Clarinet
Saxophone
Trumpet
Mellophone
Trombone
Baritone
Tuba
Snare Drum
Tenor Drum
Bass Drum
Cymbals
Melodic Percussion
Currently Play or Would Like To Learn
Possible friends/ siblings that would like band as well
Yes
No
Friends or Siblings 1
First & Last name
Phone number or I.G Page
Friends or Siblings 2
First & Last name
Phone number or I.G Page
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Language Spoken at Home
Ex: English
Guardian Information
Guardian-1 Name
First Name
Last Name
Relationship to Student
Ex: Mother
Gender
Male
Female
Prefer Not to Say
Email
example@example.com
Best Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Guardian-2 Name
First Name
Last Name
Relationship to Student
Ex: Mother
Gender
Male
Female
Prefer Not to Say
Email
example@example.com
Best Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Educational Background
School Your Attending This Year/ If Home Schooled, Put: N/A
2023-2024 Season
Does Your School Have A Marching Band? If Not, Put: N/A
If Yes, What Is Your Band Directors Name?
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: