Registration Form
Thank you for choosing to attend Omaha Conservatory’s 2024 Violin & Viola Intensive, happening July 18-19, 2024. Please fill out this form and submit payment to complete your registration.
Student Name
*
First Name
Last Name
Grade during 23-24 School Year
*
Please Select
Post-secondary studies
12
11
10
9
8
7
6
5
4
3
What school do you currently attend?
Did you attend our Violin Intensive last year?
*
Yes
No
I have attended in the past, but not last year.
If you currently have a private instructor, please list them below.
*
Instrument
*
Please Select
Violin
Viola
Current performance piece
*
Please list any dietary restrictions or allergies
Do you have any conditions or disabilities that require accommodations or support to ensure your equal participation in our program? If yes, please provide details so that we can make appropriate arrangements.Please list any conditions or disabilities we may need to make special accommodations for.
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Student Demographic Information
Age as of July 20, 2024
*
Gender
*
Please Select
Male
Female
Nonbinary/Nonconforming
Prefer not to answer
Ethnicity
*
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
Other
White
Prefer not to answer
How did you hear about Violin & Viola Intensive?
*
Please Select
OCoM email
OCoM flyer
Private instructor
School instructor
Participated in the past
Friend or family member
Recruited by a SoundWaves teacher
Social Media
Search engine
Other
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Caregiver Information
Parent or Caregiver name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Emergency contact #1 Name & Number
*
Ex. Wolfgang Mozart, 555-555-5555
Emergency contact #2 Name & Number
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Payment & Complete Registration
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Violin & Viola Intenstive Tuition
$
285.00
Violin & Viola Intensive Room & Board
Housing provided by Creighton University. All meals and transportation to and OCoM will be provided to students taking advantage of Room & Board. Students may check in the afternoon of July 18, 2024.
$
290.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
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