Demographic and Music Experience Survey
You will receive a grade when this survey is complete.
First Name: *
Your answer
Last Name: *
Your answer
Preferred Nickname (if applicable):
Your answer
Gender: *
Your answer
Grade: *
Your Cell Number: *
Use format xxx-xxx-xxxx. If none, write N/A
Your answer
Email address you check most often: *
Your answer
Your school email: *
This may be the same as above but please put it again here. This may be used to add you to class assignments that require a school account.
Your answer
Parent/Guardian #1 Name: *
First and last
Your answer
Parent/Guardian #1 Occupation: *
Your answer
Parent/Guardian #1 Cell Number: *
Use format xxx-xxx-xxxx. NO LANDLINES! If they do not have a cell, write N/A.
Your answer
Parent/Guardian #1 Preferred Email: *
Your answer
Parent/Guardian #2 Name:
First and last
Your answer
Parent/Guardian #2 Occupation:
Your answer
Parent/Guardian #2 Cell Number:
Use format xxx-xxx-xxxx. NO LANDLINES! If they do not have a cell, write N/A.
Your answer
Parent/Guardian #2 Preferred Email:
Your answer
What language(s) are spoken in your home? *
Your answer
What race/ethnicity do you identify with? *
Required
Do you qualify for free/reduced lunch?
This question is optional to answer.
Your answer
Who do you live with? *
Example: "Mom, grandma, 2 sisters"
Your answer
Do you have reliable internet access at home? *
What reliable technology do you have available to use at home on a regular basis? *
Required
How do you get to and from school? *
Please indicate if there are any foods you cannot eat (i.e. vegetarian, food allergies). *
Your answer
Which class(es) are you enrolled in? *
Required
Instrument/Voice Type/Section: *
If you are in Beginning Instruments write N/A and skip to the question below.
Your answer
Top three instrument choices: *
Only answer if you are in Beginning Instruments, otherwise write N/A.
Your answer
How long have you been singing/playing your current instrument as of today? *
Beginning Instrument students please answer for your top choice instrument.
List any other instruments you've played and how long for each. *
Your answer
Describe your prior SCHOOL music experiences. *
Ensemble type (band, choir, etc.), years involved, what school, what instrument, etc. for each
Your answer
List any other private lessons or ensembles you used to or still currently sing/play with OUTSIDE of school. *
Type, years involved, organization/teacher name, what instrument, etc. for each
Your answer
List any other sports or activities you plan to be involved in this year. *
Please indicate if any are NOT school related.
Your answer
Are you planning/hoping to participate in any honor groups this year? *
Does anyone else in your family sing/play an instrument? *
If you answered yes to the question above, please elaborate.
Who, what they play, how long, where they perform, etc.
Your answer
How would you rate your sight-reading/sight-singing ability? *
Poor
Excellent
How would you rate your technical proficiency? *
Focus on your technique/physical ability only (i.e. tone production, fingerings, etc.) NOT reading abilities
Poor
Excellent
How long do you think you will sing/play music for? *
Choose the closest answer.
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