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Patriot Pride Band 6th Grade Sign 2021-2022
Welcome to the Southeast Middle School Band for the 2020-2021 school year!
We are so excited that you want to be a part of the largest student group at Southeast.
Please sign up using this form and Mr. DeBord will contact you with additional information.
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* Indicates required question
Email Address:
*
Your Email Address
Your answer
Students First Name:
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As it would appear on the school roll.
Your answer
Name that you go by:
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Name you would like to be called in class.
Your answer
Student's Last Name:
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Your Answer
Your answer
Street Address:
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Your answer
City:
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Your answer
Zip Code:
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Your answer
Current School
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China Grove Elementary
Faith Elementary
Knollwood Elementary
Millbridge Elementary
Shive Elementary
Other:
First Choice of Instrument:
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Flute
Clarinet
Saxophone
Trumpet
Trombone
Second Choice of Instrument:
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If you do not get your first choice, which instrument would be your second choice?
Flute
Clarinet
Saxophone
Trumpet
Trombone
Do you already own an Instrument?
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Yes
No
If you checked yes to already owning a instrument which instrument do you own?
Flute
Clarinet
Saxophone
Trumpet
Trombone
Other:
Clear selection
Parent / Guardian's Name:
*
Your answer
Parent / Guardian's Email:
*
Your answer
Parent / Guardian' Phone Number:
*
Your answer
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