2020-2021 Advanced Orchestra Registration

Student Information (One Form per Student Required)

First Name *

Last Name *

Instrument (Please pick from the drop-down) *

Grade *

Address 1 *

Address 2

City *

State *

Zip *

Email *

Cell Phone *

Parent / Guardian Primary Contact

Relationship to Student: *

Mother

Father

Guardian

First Name *

Last Name *

Cell Phone *

Alternate Phone

Email Address *

Willing Hands:

Please contact me when you need volunteers.

Secondary Adult Contact

Relationship to Student:

Mother

Father

Guardian

First Name

Last Name

Check here if you live at the same address as student.

Please fill in the address below if different from student's:

Address 1

Address 2

City

State

Zip

Cell Phone

Alternate Phone

Email Address

Willing Hands:

Please contact me when you need volunteers.

Participation Contribution (Due 9/30/20)

Please check the contributions/donation you are paying at this time *

Program Contribution - includes t-shirt, instruction, group photo & MPA membership ($200)

Student Donation - to sustain the programs by building reserves and funding shortfalls ($200)

Instrumental rental - applies to instruments rented for home and school use. You will need to complete a form and get the instrument from Ms. Munday. ($200)

Require Financial Assistance - Financial Request Form is available after completing this page.

NOTE:

Concert Wear

All freshman and students new to Orchestra must purchase concert wear (Men: black tux, Women: black dresses). The prices differ based on used/new items and you will be billed later.

Current Total:

$0.00

You can pay by PayPal or by Check once you submit the form. If you are paying by PayPal, we appreciate you adding 2.25% of your total to cover the PayPal fee. Select your payment method below: *

Paying by check (please print Order Summary page and submit with payment)

Paying via PayPal (2.25% fee)

La Canada High School Music Parents Association Proudly Supports the La Canada High Schol Instrumental Music Program. Contributions / Donations you are paying can be tax deductible to the extent allowed by law. LCHS Music Parents Association is a non-profit 501(c)(3) organization. Tax ID:95-4369334.

La Canada High School Music Parents
PO Box 1307
La Canada, CA 91012
http://www.lchsmusic.org

Non-profit 501(c)(3) organization