Longy Sistema Side by Side 2017-18 Seminario Series Registration Form
This registration form will help us collect information needed for the logistics of the Side by Side series this year, as well as to assist us in caring for your child during these rehearsals and concerts.
Student's First Name *
Your answer
Student's Last Name *
Your answer
Age *
Your answer
Primary Instrument *
Parts will be assigned based on the need of each ensemble.
Your answer
Years of experience *
Please indicate the ensemble you are registering for: *
Ensemble assignments will be determined based on the level of each student and the need of each ensemble.
Current El Sistema program you are representing *
Your answer
Primary Music Teacher
Your answer
T-Shirt Size *
Please indicate any Food Allergies: *
Your answer
Parent's Prefix
Parent's Last Name *
Your answer
Parent's First Name *
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zipcode
Your answer
Home Phone
Your answer
Cell Phone #1 *
Your answer
Cell Phone #2
Your answer
Email address *
Your answer
Emergency Contact Name *
We will attempt to contact the parent(s) at the above numbers first. If no answer, this will be the next point of contact.
Your answer
Emergency Contact's Relationship *
Your answer
Emergency Contact's Phone Number *
Your answer
IPEDS Ethnicity Questionnaire *
When applying for grants and funding for its music programs, Longy is frequently asked to supply information regarding the ethnicity and race of students participating in the program. We are required to use the following ethnicity/race categories when completing the reports, so we ask each student to complete BOTH questions below (Please note that categories were not determined by Longy, but were determined by the Department of Education).
IPEDS Race Questionnaire *
When applying for grants and funding for its music programs, Longy is frequently asked to supply information regarding the ethnicity and race of students participating in the program. We are required to use the following ethnicity/race categories when completing the reports, so we ask each student to complete BOTH questions below (Please note that categories were not determined by Longy, but were determined by the Department of Education).
If you want to register a second child into the program, please select "yes" below.
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