Music Mentor (program) registration
Program Start Date: October 2020
Location: Zoom
Students will be instructed with the help of skilled volunteers that have their own recording studios or are students and experts in music, writing, singing, production, engineering and instrumental. Please fill out the form so that we can understand the best day and time that you can commit to our mentoring services. Students will need a notebook and writing utensil prior to meeting their match. A copy of the handbook and agreement will be sent after completion of form and prior to the student first session. We look forward to speaking with you soon.
Email address *
Organization or Business Name-Individual *
Email *
Phone Number *
How many students will you be registering? *
What are the first and last names and ages of the students you will be registering today? *
What day of the week works best for the students to participate?
What would be a good time for the students to participate?
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What is the length of time the students can participate? Students meet with mentors once a week we will use the information above to determine best day and time.
Creative Emajinations sessions will be recorded using Zoom. Photos and recordings will be for marketing purpose only partners are welcome and encouraged to take photos of youth during sessions. Do you agree to the following terms.
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I understand that Creative Emajinations is a 5013C Charity and all Services will be a one time member fee of donation per registered student. I/We can pay $$ prior to start of program? *
Are you needing assistance with a string or brass instrument? We receive help through our partner Band of Angels for donated instruments. There is no guarantee to local students that apply that they will receive an instrument.
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Creative Emajinations empowers students to explore music and movement through the art of music and dance to better assist you please answer the following questions:
Name or Representative of person completing form
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