Youth Performance Interest Form 
The Chrysler Museum of Art is a dynamic performance venue. Fill the Museum with the sound of music! 

This form is for teachers to use in order to request a performance date. Plan to hear from the School & Teacher Programs Coordinator within two weeks of receipt. 

Filling out this form does not guarantee a performance date. 

(Above image: Philip Evergood, Music, 1933, revised 1959, Oil on canvas.) 
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What is your first and last name?  *
What is your email address? (The one you check.)  *
What is the name of your school? Please also include the district. *
When would you like to do this performance?  *
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What is an alternative date?  *
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What type of ensemble will be performing? 
(Check all that apply.) 
 *
Required
How many students?  *
Have you brought a group to perform at the Chrysler previously?  *
What do you think you'll need? 
What might you be bringing? 
This will help the School & Teacher Programs Coordinator. 
(Check all that apply.) 
 *
Required
Share a draft itinerary. The Museum opens at 10:00a.m. and is closed on Mondays. This form is for weekday requests only.  *
What else do we need to know? 
Submit
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