Name (Director/coordinator/principal) *

First Name

Last Name

Phone

(###)

###

####

Name (Secretary/assistant)

First Name

Last Name

Phone

(###)

###

####

Days *

Monday

Tuesday

Wednesday

Thursday

Friday

Music Class *

Would you like to include a music class as part of your standard curriculum?

Yes

No

Type of workshop *

Please select the type of workshops you are interested in offering at your institution.

Rock band

Worship band

Music production

Recorder ensemble

Strings ensemble

Vocal ensemble

Bells ensemble

Private lessons *

Would you like us to offer private lessons at your institution?

Yes

No