Teacher/Contact

E-mail

School Address ZIP

Contact's work phone (no dashes)
Fax (no dashes)

Contact's home phone (no dashes)

Type of performance group (check one):
Choral Concert Band Stage Band Jazz Band Orchestra
String Ensemble Dance Drama Other (please specify)

Title of performance piece (this will be listed in the program):

How many students will be performing?
Grade level (check all that apply): K 1st 2nd 3rd 4th 5th
6th 7th 8th 9th 10th 11th 12th
Age range:

Brief description of performance, including length

Do you have any technical requirements? (power, sound, staging, etc.)

Preferred dates and times for performing(choose 1 for your 1st choice, 2 for your 2nd choice, etc... AND select a preferred starting time for your performance, either morning (AM) or afternoon (PM)).

Tuesday, 5/17 1 2 3 4 AM PM

Wednesday, 5/18 1 2 3 4 AM PM

Thursday, 5/19 1 2 3 4 AM PM

Friday, 5/20 1 2 3 4 AM PM

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