26-27 Flute Choir Registration Form
Registration due September 4th Mondays, September 21st - November 30th 6:30 - 8:00pm (excluding 10/12 and 11/23) Concert - Monday, December 7th
Musician Information
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Anticipated High School Graduation Year
*
Gender
*
Female
Male
Non-binary
I prefer not to answer
Other
Pronouns
*
she/her/hers/herself
he/him/his/himself
they/them/their/themself
ze/hir/hirs/hirself
Other
Which category best describes musician's ethnicity? Check all that apply.
*
I prefer not to disclose
American Indian/Alaska Native
Asian
Black/African American
Caucasian
Hispanic/Latinx
Middle Eastern
Native Hawaiian/Pacific Islander
Other
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Musician Contact Information
Preferred Email
*
All ESYO members should have an active personal email account for ensemble communication. Do NOT use an active school account. ESYO students are expected to have an active personal email if age appropriate.
Gmail Address
*
Google Classroom is the official hub for ESYO communication and online learning. All ESYO members are REQUIRED to have a personal Gmail/Google Account in their name if it is age appropriate. Online safety is top of mind for all parents. ESYO online classrooms are facilitated by ESYO conductors and ensemble managers. Secure Google accounts help keep our virtual classrooms safe and secure. Do NOT use a school email account.
Preferred Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
Please enter a valid phone number. Your cell phone number will only be used to send emergency notifications about rehearsal cancelations. By providing your cell phone number you are opting-in to receive emergency text notifications from ESYO.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Membership Information
Years of Study on Flute
*
NYSSMA Level
School Information
School Name or Homeschool
*
Grade
*
Current grade
School District
*
School Music Teacher Name
*
First Name
Last Name
School Music Teacher Email
*
example@example.com
Private Music Teacher Name
First Name
Last Name
Private Music Teacher Email
example@example.com
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Parent/Caregiver Information
Name
*
First Name
Last Name
Preferred Email
*
example@example.com
Preferred Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
Please enter a valid phone number. Your cell phone number will only be used to send emergency notifications about rehearsal cancelations. By providing your cell phone number you are opting-in to receive emergency text notifications from ESYO.
Format: (000) 000-0000.
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Additional Parent/Caregiver Information
Name
*
First Name
Last Name
Preferred Email
*
example@example.com
Preferred Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone Number
Please enter a valid phone number. Your cell phone number will only be used to send emergency notifications about rehearsal cancelations. By providing your cell phone number you are opting-in to receive emergency text notifications from ESYO.
Format: (000) 000-0000.
I am applying for Tuition Assistance
*
Yes
No
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Application for Financial Aid 26/27
1a. What is your total adjusted gross income? Actual Last Completed Tax Year
*
From 1040: line 37, or form 1040A: line 21. Include a combined TOTAL of adjusted gross income for ALL supporters.
1b. What is your total adjusted gross income? Estimate Current Tax Year.
*
2a. Non-taxable income and/or benefits (listed below) received by your family: Actual Last Completed Tax Year
*
2b. Non-taxable income and/or benefits (listed below) received by your family: Estimate Current Tax Year
*
3a. TOTAL INCOME Actual Last Completed Tax Year
*
3b. TOTAL INCOME: Estimated Current Tax Year
*
4. Please list any extenuating circumstances and subsequent financial implications that show your need for financial aid.
*
5. Household size
*
6a. Unemployment: Enter the number of months the primary wage earner was unemployed during the actual last completed tax year and the approximate monthly impact:
*
6b. Unemployment Enter the number of months the secondary wage earner was unemployed during the actual last completed tax year and the approximate monthly impact:
*
Upload Supporting Documentation
Upload a copy of your most recently filed IRS Income Tax Return (1040 or 1040A)
*
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This form must be accompanied by a copy of the first 2 pages of each supporter’s most recently filed IRS Income Tax Return (1040 or 1040A). Please use a dark permanent marker to conceal any social security numbers listed on all included forms. Musician for whom assistance is sought MUST be listed as a “Dependent” on line 6c of the included 1040 or 1040A.
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of
Additional Tax Documentation
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of
I hereby affirm....
*
By checking this box, I hereby affirm that the information contained within this form and its attachments are accurate, true, and complete to the best of my knowledge.
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Pay Your Tuition
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Flute Choir
$350.00
$
350.00
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