Creative Music Registration Form
Audition Information
Perferred Audition Date
*
-- Select an option --
Date 1
Date 2
Date 3
Part 1: Arts Student Section
Name
*
Age
*
Birthdate
*
Gender
*
School Name
*
School District
*
Phone Number
*
Email Address
*
Primary Instrument
*
Years Studied
*
Have you participated in a Kimmel Center Arts program before?
*
Yes
No
How did you hear about us?
*
Part 2: Parent/Guardian Section
First Name
*
Last Name
*
Relationship to Student
*
Email Address
*
Phone Number
*
Address
*
Address
*
Address 2
City
*
State
*
Zip Code
*
Country
*
Comments or Questions
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