EmailMe Form - Spring 2018-2019 JCC Audition Request

Child's Name *

First Last

Grade in School *

School Child Attends *

Gender *

Male

Female

Age *

Birthday *

MM / DD / YYYY

Ethnicity *

Parent or Guardian *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Contact Phone *

### - ### - ####

Email *

Are you in a choir at school? *

Yes

No

Are you in a choir at church or synagogue? *

Yes

No

Are you in band or orchestra? *

Yes

No

If yes, what instrument?

Have you taken private instrument lessons? *

Yes

No

If yes, what instrument?

How long?

What are the other major activities are you involved in? *

Is there anything special you would like us to know about your child? *

How did you hear about the JCC? *