2022-2023 KHS Band Interest Survey
If you have any questions email Director Anithio Miller at anithio.miller@polk-fl.net. Please visit khsband.org for more information about the Kathleen High School Band program.
Email *
Student Name ( First, Last) *
Telephone Number *
Parent/Guardian Name (First, Last) *
Parent / Guardian Email Address
New Member or Returning Member? *
What school do you currently attend? *
Instruments or section in Band, Dance or Color Guard *
Current Grade *
Years of experience on your instrument, dancing, cheer, or color guard? *
By signing this form, I agree that all information is accurate to my best knowledge. I understand that I must remain in good standing academically and musically to participate in the KHS Band.  Please initial below. *
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