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Saturday Music Classes
Please fill out the following questions for our records
Name of Participant
Participant Date of Birth
Full Street Address
Please include neighborhood and Zip Code
Prefer not to say
Which Languages do you Speak?
What school do you attend?
What is your current grade level?
Are you currently an ELL student?
ELL Stands for "English Language Learner"
Are you a former ELL Student?
Do you live in a housing development?
Do you receive food Stamps or free School lunch?
Have you participated in other Sociedad Latina programs?
If yes to above questions, which program?
Parent/Guardian phone number
Are there any medical conditions we should be aware of?
We typically photograph performances and lessons to use in News letters and success stories of our student, by checking the boxes below please indicate if you will allow photos of your student to be used in these materials
Which instrument classes are you interested in?
You can select up to two classes
Classes occur in seven week cycles, we do not allow student to miss more than 1 class per session. Can you commit to this schedule?
Send me a copy of my responses.
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