STUDENT INFORMATION FORM

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North Allegheny Indoor Percussion 2012

First Name *

Last Name *

Grade Level *

Are you currently in any of these ensembles? *

(check all that apply):

Marching Band

NASH Wind Ensemble

NAI Wind Ensemble

NASH Symphonic Band

Jazz I

Jazz II

Jazz III

Required

Do you plan on being involved with the 2012 NA Musical? *

Yes

Contact Info

E-mail Address *

Cell Phone Number *

format: xxx-xxx-xxxx. If no cell, just write NONE

Home Phone Number *

use this format: xxx-xxx-xxxx

Parent/Guardian 1 *

(first and last name)

Parent/Guardian 1 E-Mail *

Parent/Guardian 1 Phone *

format: xxx-xxx-xxxx. If same as above, just write SAME AS [HOME/CELL]

Parent/Guardian 2

(first and last name)

Parent/Guardian 2 E-Mail

Parent/Guardian 2 Phone

format: xxx-xxx-xxxx. If same as above, just write SAME AS [HOME/CELL]

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