PO Box 40, Yarmouth, Maine 04096  (207) 751-8031

www.maineyouthorchestra.org

E-mail:  Info@maineyouthorchestra.org

 

 

 

 

REGISTRATION FORM 2007-08

 

Please complete and return with your season tuition by mail or in person by September 12, 2007. 

 

Membership fee (September-May):  $175 per student, $150 for subsequent members of family.  Checks should be made payable to MYO.  All fees must be paid in full by September 12, 2007 and are non-refundable.

 

A small amount of financial aid is available for students who need assistance in paying their annual membership fee.  Please contact the MYO Board of Directors at PO Box 40, Yarmouth, ME 04096; 207-751-8031; or info@maineyouthorchestra.org for more information.

 

Amount Due__________                 Amount Paid_________                   Check no._______

 

Student’s Name_____________________________________________Birth Date_________________________________

 

Mother’s Name_________________________________Father’s Name__________________________________________

 

Student’s Address_____________________________________________________________________________________

 

_______________________________________Phone Number____________________Cell phone____________________

 

Student’s e-mail______________________________________________________________________________________

 

Parents’ e-mail_______________________________________________________________________________________

 

How often is e-mail checked? ______daily_____several times per week_______weekly__________less than once a week

 

What is the best way to contact student?_________________________________________________________________

 

School____________________________________________________________________Entering grade____________

 

Primary Instrument__________________________Years of Study________Currently taking lessons?_______________

 

Music Teacher’s Name & Phone_______________________________________________________________________

 

Music Camps or Workshops Attended (include dates)_______________________________________________________

 

__________________________________________________________________________________________________

 

New Members:  How did you hear about MYO?_____________________________________________________________________

 

 

________________________________                                                                     __________________________________

Student signature                                                                                                                 Parent Signature

 

Publicity Release Consent

I understand that MYO’s publicity materials may include statements by and/or photographs of MYO participants, and I consent to such use of my child’s comments and photographic likeness.

 

 

Parent Signature/Date