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Rock n Roulette 2025 Band Member Application
Women and gender-expansive musicians will use this application form to apply to participate in 2025 Rock n Roulette as a band member. To ensure an amazing experience for all participants, we need to carefully consider the number and types of instruments in each band. This approach allows us to maintain a diverse mix of musicians, which may not be possible with a first-come, first-served registration system. If chosen, the information provided in your application helps us to put you in a band that we think will suit you best. Each band will have eight weeks to write two original songs and learn one cover song, and will have a goal to raise $1,000 for She Rock She Rock!
Basic Information
Applicant's Full Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you 19 years of age or older?*

YesNo
Do you identify as female or gender-expansive?*

YesNo
Location Information
Do you have a space that can host your band's practices (we can provide necessary equipment if needed)?*

YesNo
How far are you able/willing to travel to go to band practice?*

Less than 10 milesBetween 10-20 milesMore than 20 miles
Do you have transportation to get to rehearsal?*

YesNo
Are you able to accommodate evening and/or weekend rehearsals, ensuring at least one practice session per week with your bandmates during the 8-week program?*

YesNo
Is there anything else you need us to know about your schedule and/or location needs?
Music Information
Instrument(s) you want to play (you must have a basic knowledge of each instrument you choose):*

Guitar (must be electric or acoustic-electric)BassKeyboardsVocalsDrums
If you picked multiple instruments, please rank them here:
Example: 1st choice-guitar, 2nd choice- drums, etc
What styles/genres of music do you like to play?*
Please describe your past musical experience*
Is there anything else you'd like us to consider for placing you in a band?
Fundraising
Do you have nonprofit fundraising experience?*

YesNo
If no, would you be interested in a call/session with a fundraising coach? (Our board chair is a fundraising expert and loves sharing fundraising ideas!)

YesNo
Agreements

If your application is chosen to participate in Rock n Roulette...
I understand my role is to not only participate in a band, but to individually fundraise at least $200 for She Rock She Rock.
I agree that I will be at the final showcase at Hook & Ladder on December 7, 2025.
I agree to be an active band member by attending all of the band practices.
I agree to embrace the diverse range of talent within my band, as members may have varying playing experience. Rock n Roulette is designed to bring together musicians of various skill levels and backgrounds for a collaborative and exciting fundraising experience. Bands formed during this event are short-term collaborations and serve as a platform for camaraderie, creativity, and community building.
I grant permission to SR2 to use images of me from Rock n Roulette. Use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of me for use in materials that include, but may not be limited to printed materials such as brochures and newsletters, videos, and digital images such as those on the She Rock She Rock website. I give unrestricted permission for my image to be used in print, video, and digital media. I agree that these images may be used by She Rock She Rock for a variety of purposes and that these images may be used without further notifying me. I do understand that my last name will not be used in conjunction with any video or digital images.
We will be in touch with you regarding your application by September 30, keep an eye on your inbox!
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Rock n Roulette 2025 Band Member Application

Basic Information

Location Information

Music Information

Fundraising

Agreements

We will be in touch with you regarding your application by September 30, keep an eye on your inbox!