Copy of Reach Interest List 2017 Thank you for your interest in the Charlotte Ballet Reach program! Please take a few minutes to complete this survey to secure your student's spot for auditions. Question Title * 1. Please provide your contact information so that we may send you a reminder closer to the audition date. Name: Address: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Email Address: Phone Number: Question Title * 2. Which recreation center do you plan to attend for the audition? Ivory Baker Recreation Center - Monday, July 31, 2017 5 PM Naomi Drenan Recreation Center - Tuesday, August 1, 2017 5 PM Sugaw Creek Recreation Center - Wednesday, August 2, 2017 5 PM Bette Rae Thomas Recreation Center - Thursday, August 3, 2017 5 PM Hickory Grove Recreation Center - Friday, August 4, 2017 5 PM Please note Albemarle Road students can audition at any site. Question Title * 3. What school will your student attend during the 2017/2018 school year? Question Title * 4. What grade level will your student be entering for the 2017/2018 school year? 1st 2nd 3rd 4th 5th Other Question Title * 5. How did you hear about the Reach program? email from CMS schools sign at the recreation center email from Charlotte Ballet word of Mouth flyer charlotteballet.org Other (please specify) Done