OAYO's Honors Orchestra Registration Form 2017-2018 Season
Please fill out this form completely. After you press submit your child will be successfully registered for the Honors Orchestra program. We will send out confirmation emails a week before the program begins. Honors tuition fees will be due by the second week of the program and we will send you a notification about fees due using our new student database called Charms. All fee payments can be made through Charms and we will send you information on how to log into this system when the program begins.
Student First Name
Your answer
Instrument
Your answer
Student Information
Years of Playing the Instrument
Your answer
Student Last Name
Your answer
Do you play an instrument with your school orchestra or band?
Have you been in an OAYO program before?
Student's Cell Phone
Your answer
Home Phone Number
Your answer
Primary E-Mail contact:
Your answer
Secondary E-Mail contact:
Your answer
Third E-Mail contact:
Your answer
Address
Your answer
City
Your answer
State
Zip
Your answer
School District in which they live:
School
Your answer
First Name of School Music Teacher
Your answer
Last Name of School Music Teacher
Your answer
School Teacher's Email
Your answer
First Names of Private Instructor
Your answer
Last Name of Private Instructor
Your answer
Private Instructor's Email
Your answer
Do you receive either free or reduced lunch at your school?
Grade as of Fall 2017
Your answer
Student's Birthday
MM
/
DD
/
YYYY
Does any member of your family play an instrument or sing?
If so, what instrument and who?
i.e. Mother plays the piano.
Your answer
How do you listen to music?
Check all that apply within the last three months
Parent or Guardian Information
Father First Name
Your answer
Father Last Name
Your answer
Father's Cell Phone
Your answer
Father's Cell Phone Provider (Verizon, Sprint etc.)
Your answer
Mother First Name
Your answer
Mother Last Name
Your answer
Mother's Cell Phone
Your answer
Mother's Cell Phone Carrier (Verizon, Sprint etc.)
Your answer
I am interested in carpooling opportunities for my child:
I believe the business/company that I work for may be interested in sponsoring or underwriting an OAYO program or concert.
Please provide the contact information for the student’s grandparents, or a special family member or friend, so we may share event information with them.
Grandparent First Name
Your answer
Grandparent Last Name
Your answer
Grandparent Address
Your answer
Grandparent City
Your answer
Grandparent State
Your answer
Grandparent Zip Code
Your answer
Grandparent Email Address
Your answer
Grandparent Phone Number
Your answer
Grandparent or Other Relative First Name
Your answer
Grandparent or Other Relative Last Name
Your answer
Grandparent or Other Relative Address
Your answer
Grandparent or Other Relative City
Your answer
Grandparent or Other Relative Zip Code
Your answer
Grandparent or Other Relative Email Address
Your answer
Grandparent or Other Relative Phone Number
Your answer
Required Signatures:
Student - I state that I meet the requirements described in the Student Information Sheet and I want to register for membership in the OAYO Honors Orchestra. By marking a“ X “in the box I am signifying my signature.
Required
Parent - I have read and understand the Student Information Sheet. I agree to the conditions of participation and give permission for my child to participate in the OAYO Honors Orchestra. By marking a “ X“ in the box I am signifying my signature.
Required
Your Answers to the following questions are helpful but not required.
The following information will be used for statistical purposes only and will not affect your selection into the OAYO Honors Orchestra.
Gender
Ethnic Description
Questions? Contact Rana Scarlett-Johnson at rana.scarlett-johnson@oayo.org or 402-238-2044
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