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Expression of Interest Form,                            Pop & Rock Orchestra, 2016-2017
2017 Rehearsal Schedule 11:00-13:00 , Holy Family Senior School Halla as follows:
08.01.2017, 22.01.2017
05.02.2017, 19.02.2017
12.03.2017, 19.03.2017
02.04.2017, 30.04.2017
07.05.2017, and 12.05.2017 (concert)

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Ainm an Dalta     Student Name *
Aois an Dalta       Student Age *
Dáta breithe         Date of birth *
Sonraí Teagmhála     Contact details *
Rphost                  Email *
Uimhir ghutháin phóca    Mobile phone no. *
Seoladh                 Address *
Uirlis                       Instrument *
Múinteoir reatha  Current teacher *
Nasc d'fhíseán 30 soicind (más ann)                   Link to 30 second clip (if available) *
Ráiteas Pearsanta - cén fáth gur mhaith leat bheith páirteach.                                                Personal statement - why you would like to partake. *
I understand that Rock and Pop Orchestra rehearsals take place Sunday mornings 11:00-13:00 noon, €75 from Jan-May 2017, fees for term to be paid at first rehearsal.                                                     10% discount for one sibling. *
Beidh mé ar fáil le haghaidh na ceolchoirmeacha seo a leanas:                                                                 I confirm that I am available for the following performances:   *
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