Louisville Instrumental Music Department Fifth Grade Interest Survey

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Louisville Instrumental Music Department Fifth Grade Interest Survey

Please Fill Out And Submit By Friday, April 10

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Student's Name *

Parents Name(s) *

Address *

Telephone Number *

Parent(s) Email Address *

Homeroom Teacher *

I Am Interested In Playing (indicate top choice) *

Flute

Clarinet

Saxophone

Trumpet

Trombone

Drum

Required

I Am Interested In Playing (indicate second choice) *

Flute

Clarinet

Saxophone

Trumpet

Trombone

Drum

Required

Please Check One: *

I plan to attend the 4:30 meeting on Tuesday, April 14

I plan to attend the 7:00 meeting on Tuesday, April 14

I am interested but unable to attend, please contact me at the number listed above

I am not interested at this time.

Required

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