Student Information
q Mr. q Miss First Name Last Name
Address
City, State, Zip
Home Phone Student E-mail for notifications
Applicant Date of Birth / / Grade as of September 2004
Instrument Years Played as of September 2004 _____________
School:
School Instrumental Teacher:
Private Teacher:
How many years have you been in the GSP youth orchestra program as of September 2004
If you were in a GSP youth orchestra ensemble in 2003-2004, which one?
q String Ensemble (Miss Swierczewska) q Concert Youth Orchestra (Mr. Spaulding) q Symphonic Youth Orchestra (Mr. Hollander)
Brief Biography for Release to Media (four sentences):
Please attach photo if available.
Name of Hometown Newspaper:
Other important information we should know:
Guardian Mailing Salutation (i.e. Mr. & Mrs. John Smith):
Guardian First & Last Names:
Address
City, State, Zip
Home Phone Work Phone:
***GUARDIAN E-mail for notifications***
This is very important. The GSPYO communicates about attendance, inclement weather cancellations, changes in rehearsal, performance information, and musical opportunities via e-mail.
Payment Information
Annual Membership fee of $90.00 payable with the application and $80.00 per child if there are two or more members from same family.
Method of Payment: qCheck (made payable to the Garden State Philharmonic) q Visa q MasterCard
Name on Card
Credit Card Number Exp. Date /
I hereby make application for my child to participate in the Garden State Philharmonic Youth Orchestra Program. I release the GSP Symphony Society from all responsibility in the event of accident or injury. As a member of the GSP Youth Orchestra Program, I must be a member in good standing of my own school band or orchestra. (Membership in the school band or orchestra is extremely important to the development of young musicians and is vital to our success.)
Parent Signature Student Signature