Middle and High School Registration Form
 

1.

 
Thank you for using the online registration form for the Eugene Symphony's Middle and High School Youth Concert.

Concert Details:

Date: Tuesday, February 14, 2012

Times: 10:15 - 11:00 AM & 12:30 - 1:15 PM

Fee: $5.00 for each student and adult. No one will be denied access because of inability to pay. Please indicated below the number of students you anticipate being unable to pay.

Payment: Please pay fee within one week following the concert. Please make your checks payable to Eugene Symphony. Schools will be charged for cancellations less than two weeks prior to the concert.

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1. School Name

2. District Number

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3. Contact Person

4. Contact Position

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5. Contact E-mail Address

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6. School Mailing Address

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7. City

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8. Zip Code

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9. School Phone Number

10. Grades Attending

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11. Concert Preference

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12. Number of Students Attending

13. Number of Chaperones Attending

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14. Number of Students/Chaperones Unable to Pay

15. Number of Wheelchairs

16. Estimated Number of Buses

17. Special Seating Needs (Other Than Wheelchairs)