2016-2017 DLES Orchestra Registration

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Student First Name: *

Student Last Name: *

Student Homeroom Teacher: *

Mrs. McWilliams

Ms. Cho

Mr. Bredland

Mr. Sporgitas

Ms. Abelman

Ms. Melvin

Mrs. Madden

Ms. Haas

Ms. Schneider

Ms. Pagnotta

Ms. Wilder

Mrs. Sillers

Ms. Bahel

Ms. Dorsey

Ms. Greene

Ms. Jacobs

Other:

Your Student's First Instrument Choice: *

Mrs. Townsend will be working with EVERY child to help identify which instrument they will be most successful at. Please remember that there are some instruments that have a class size limit so it is important to have a couple instrument options.

Violin

Viola

Cello

Bass

Your Student's Second Instrument Choice: *

Violin

Viola

Cello

Bass

4th Graders: Would your student also like to try a band instrument before committing to the orchestra program?

Yes

Clear selection

Parent/Guardian Names: *

Parent Email Addresses: *

Parent Phone Number: *

Is there anything extra you would like to share about your child?

Example: Your child is being served by a specialist (physical therapist, special education teacher, speech or hearing clinician, etc.). Or if your child has any physical features/concerns that might be a consideration in choosing an instrument (asthma, braces, crooked or missing teeth, tiny fingers, etc.).

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