SCHOOL REGISTRATION FORM

Thank you for registering for the 2023/24 Link Up Program: The Orchestra Swings. If you have questions or need assistance filling out this form, please contact: Katy Vizdal, Education & Community Engagement Director, katy.vizdal@eugenesymphony.org, 541-687-9487 x1116.

Program Details available on the Eugene Symphony website, HERE.

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* 1. School Name

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* 2. District Number (eg. Eugene-4J, Springfield-19, Bethel-52)

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* 3. Is your school Title I?

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* 4. Please select the category below that best describes your school:

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* 5. Primary Contact (Name)

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* 6. Contact Position

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* 7. Contact E-mail Address

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* 8. Contact Phone Number

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* 9. Billing Contact (Name, Title)

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* 10. Billing Contact (E-mail Address)

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* 11. School Mailing Address

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* 12. City

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* 13. Zip Code

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* 14. Grade(s) participating in the Link Up program

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* 15. Please confirm which professional development training you will attend.(Attendance required)

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* 16. If available, do you want a physical copy of the Link Up: The Orchestra Swings Teachers Guide?

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* 17. YOUTH CONCERT: Select which culminating Link Up Youth Concert your school will attend:

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* 18. Number of students participating in Link Up / attending the Youth Concert

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* 19. Number of chaperones (including teachers) attending Youth Concert

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* 20. Number of Scholarships Requested (students only)

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* 21. Estimated number of buses for Youth Concert

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* 22. Please share any special seating accommodations we can provide here: (eg. Wheelchair accessibility, preferred seating area in the Silva Hall, etc.)

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* 23. How did you hear about this program?

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* 24. Please list additional questions or comments you have here:

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