Student first name *

Student surname (last name) *

Date of birth (please note it is month, day, year) *

Gender *

School year in 2021 *

School attending in 2021 *

School principal name *

Which band is your child in? *

Instrument(s) played (If more than put the main instrument first) *

Is your child interested in joining the Junior or Senior Big Band? These both rehearse on a Monday night. Students must be in one of the main bands to be in the big bands. There is an additional cost for these bands.

Parent contact name 1 *

Parent contact 1 mobile *

Parent contact 1 email *

Parent contact 2 name (optional)

Parent contact 2 mobile (optional)

Parent contact 2 email (optional)

Home phone number (optional)

Student email (optional)

Home address (street number and name) *

Suburb *

Postcode *

Emergency contact name (if parents are uncontactable) *

Emergency contact number *

Medical Conditions - please note that if asthma or anaphylaxis is identified you must provide a current copy of the plan for your child if they are participating in the program in 2020. (Please put N/A if not applicable). *

Treatment and medication required (Please put N/A if not applicable). *

Asthma and/or Anaphylaxis plan to be submitted. *

I agree by checking this box that I have read the NSW Department of Education's Behaviour Code for Students (see link below) and agree that my child will adhere to the code. https://education.nsw.gov.au/student-wellbeing/attendance-behaviour-and-engagement/student-behaviour/behaviour-code *

I agree by checking this box that I am aware that my child must be a part of their school band program in order to participate in the AACSB. If there is no band at your child's school please select N/A. *

I agree to return the "School Approval Form" and "Invoice" in order for my child to participate in the AACSB Program. I am aware that these will be emailed to me if my child is participating in the program in 2021. *