Rosa International Middle School Band/Orchestra Registration 2016/17
Please do not complete until LC and Adviser have been assigned. Please submit by September 16, 2016. All information provided is guaranteed to be secure.
Current School Year Information
Please complete this form carefully. Since this information goes into a formal database that is used throughout the year, please be sure to use correct capitalization. A parent/guardian must be present when completing.
Band/Orchestra Participation Information
Student's LAST NAME
Student's FIRST NAME
Student's current GRADE
Student's Current Learning Community (LC)
Student's Current Adviser
LAST NAME ONLY - i.e. DelRossi, not Mr. DelRossi
Which ensemble/group are you registering for?
Choose one. Note: This is NOT the Jazz Band registration page
6th Grade Band
7th Grade Band
8th Grade Band
6th Grade Orchestra
7th & 8th Grade Orchestra
Select the instrument you currently play
If you are new to the program, select which instrument you wish to play
Bb Clarinet (regular)
Percussion (snare/bass drum)
Instrument Serial Number
Needed in the event an instrument is lost or accidentally switched with another. It can be found engraved on the BODY of wind instruments and INSIDE the f-hole of string instruments. Rentals will have the serial numbers on the tags. If there is no number (or letter) serial number, please write NONE below.
Did you play the instrument selected above LAST year?
If YES selected above, how many years have you been playing this instrument?
Do you play another instrument?
If YES selected above, which one?
If you play another instrument, are you interested in playing it in another ensemble?
Are you currently taking private lessons on this instrument?
If YES selected above, with whom?
Your private teacher's name - this is helpful if someone else is looking for a private teacher
If you are an incoming 6th grade student only, which elementary school did you attend?
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