Rosa International Middle School Band/Orchestra Registration 2012 - 2013
Please submit no later than September 21, 2012. All information provided is guaranteed to be secure.
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Current School Year Information
Band/Orchestra Participation Information
Student's LAST NAME *
Student's FIRST NAME *
Student's current GRADE *
Student's Current Learning Community (LC) *
Student's Current Adviser *
Last name only - no Mr. or Mrs.
Which ensemble/group are you registering for? *
Choose one. Note: This is NOT the Jazz Band registration page
Select the instrument you currently play *
If you are new to the program, select which instrument you wish to play
Instrument Serial Number *
Needed in the event an instrument is lost or accidentally switched with another. It can be found engraved on the BODY of wind instruments and INSIDE the f-hole of string instruments. Rentals will have the serial numbers on the tags. If there is no number (or letter) serial number, please write NONE below.
Did you play the instrument selected above LAST year? *
If YES selected above, how many years have you been playing this instrument?
Do you play another instrument? *
If YES selected above, which one?
If you play another instrument, are you interested in playing it in another ensemble? *
Are you currently taking private lessons on this instrument? *
If YES selected above, with whom?
Your private teacher's name - this is helpful if someone else is looking for a private teacher
If you are an incoming 6th grade student only, which elementary school did you attend?
IMPORTANT PERSONAL INFORMATION
Please fill in completely and carefully.
Parent/Guardian First/Last Name *
Street Address *
Zip Code *
Home Phone *
format xxx-xxx-xxxx (please include dashes)
Parent/Guardian EMAIL address *
Re-type parent/guardian EMAIL address *
for confirmation
Student EMAIL address
Not required, but VERY helpful. Will not be used for any purpose other than sending updates & reminders
Re-type STUDENT email address
Parent/Student Program Participation Consent
Have BOTH the student and parent/guardian read the Instrumental Music Program Course Expectations and Outline? *
This is available on the Music Program Website, by hard copy in the band room, and in the Special Area Handbook.
Do you BOTH agree with the terms set forth in the outline? *
You understand that semi-private lessons (which are crucial to your child's success) take place once a week for 40 minutes. These lessons are pulled from ALL classes and ROTATE each week so the same class period is not missed. This amounts to missing 40 minutes of one class one time out of every 2100 minutes of instruction. *
Remember: Flexibility exists for conflicts with tests, etc. Students must alert Mrs. Mark when there is a conflict and work out a time to re-schedule the lesson BEFORE the lesson is scheduled to take place.
Do you understand that occasional AFTER SCHOOL REHEARSALS are scheduled in advance and attendance at all is REQUIRED? *
Rosa Games/Meets are excused. The schedule is set for the entire year. Please be sure to mark your calendars and try not to schedule appointments, etc., on the few days that are set aside for these important rehearsals. The program can not function without these extended rehearsals once a month.
Are you aware of all performance dates and that participation in CONCERTS is required? *
If a student is unable to attend a concert for any reason, including illness, a report must be writen as the only form of re-assessment. Concerts count as the mid-term and final exams for the course.
Choosing YES below acts as my signature and approval for my child to participate in the Band or Orchestra at Rosa International Middle School. *
Name of Parent/Guardian who completed this form *
First and Last Name Required
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