Brant County Singers Application Form

Brant County Singers Application Form
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
I am over 18 years old.
Email
example@example.com
Cell phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Do you know which section you sing in? Don't worry if you don't, we'll figure it out together.
- Our rehearsal space is located downstairs at Sydenham-Heritage United Church. There is a lift at the side of the building that can be used to access the downstairs space if needed.
- 1. Do you have any accessibility needs that would help you participate comfortably?
- If yes, please describe:
- 2. Do you require any mobility-related accommodations (e.g., seating preferences, assistance with stairs, walking support)?
- If yes, please describe:
- 3. Do you use any assistive devices (e.g., cane, walker, wheelchair, braces) that we should plan for in our space or activities?
- If yes, please describe:
- Tell us a bit about yourself:
- Section:
- Music No. Issued:
- Fees Paid:
- Date fees paid
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Folder No. Issued:
- Membership Binder Issued:
- Scarves Issued:
- Date Scarves issued:
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Polo size:
- Date Polo Issued:
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Name Tag:
- Date name tag issued:
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: