MTV (2019-20) 5th Grade Instrument Sign-up Form
Welcome to our Band/Strings program! The form below officially signs your child up to play an instrument in 5th grade. After completing this form, you are responsible for obtaining an instrument, music book, and correct instrument accessories for your child. Your child's instrument lessons will begin in September of 2020.
If you have any questions, please contact Mrs. White at
or Mr. McCabe (Strings) at
PLEASE COMPLETE THIS FORM BY JUNE 17, 2019.
Mountview Road School
Student's 4th Grade Teacher
Student's First Name
Student's Last Name
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Relation to the Child
Home Phone Number
Cell Phone Number
Work Phone Number
Best contact number to reach you
(If undecided, select up to 3 and Mrs. White will meet with your child to select his/her best instrument)
Please select the answer describing the student's prior instrumental experience...
Played a string instrument at MTV in 4th grade, but would like to join the 5th grade band this year
Played a band instrument at MTV in 4th grade, but would like to join the 5th grade strings this year
Played an instrument in another school and is continuing on the same instrument
Played an instrument in another school, but would like to play a different instrument
Never played an instrument before, but is excited to try something new
Which instrument vendor/company did you choose?
Rent from Music & Arts (online... see .pdf link "Instrument FAQ" for helpful instructions on last page)
Rent from Schmeed's Music (go directly to the store)
I own the instrument or will be borrowing from a friend/family member (note: please send the instrument to school for Mrs. White to check quality or take to a music store for evaluation and possible repair)
My child and I have read the linked .pdf letter "Instrument FAQ" containing the expectations and responsibilities, and understand that our commitment to the Band or Strings program is for the entire school year.
Yes, we have read the letter and agree to fulfill our commitment to the instrumental music program for one full school year (Sept. through June)
Since school is no longer in session for the summer, you will receive a follow-up email within 2-4 weeks of submitting this form to confirm your child's participation in the Band/Strings program. If you do not receive a confirmation email after that time frame, please try re-submitting your sign up form or email us directly at
Please refrain from renting your child's instrument until you have received the confirmation email. Thank you.
Never submit passwords through Google Forms.
This form was created inside of Hanover Township School District.
Terms of Service