Meet the Instruments Musician Visit Request

Step 1 of 4

Comments

This field is for validation purposes and should be left unchanged.

Event Information

How many artists?(Required)

Please enter a number from 1 to 10.

How many hours?(Required)

Please enter a number from 1 to 5.

What musical instrument(s) do you prefer?(Required)

Please list your top 3 preferred dates:

Preferred Date 1(Required)

*Please note, requests must be submitted at least 4 weeks in advance.

Preferred Date 2(Required)

Preferred Date 3(Required)

Please list your preferred timeframe:

Start Time and End Time (can be multiple options)(Required)

Please estimate the total number of the following that will be engaging in the visit:

How many adults will be present?(Required)

How many students will be present?(Required)

Grade Levels(Required)

Kindergarten

1st

2nd

3rd

4th

5th

Check all that apply

School Information

Are you a(n):(Required)

Choose Your County:(Required)

School District(Required)

School/Group Name(Required)

School Address(Required)

Street Address Address Line 2 City State ZIP Code

School Phone(Required)

Would you like to request financial assistance?(Required)

Yes

Is your school designated as a Title 1 school?(Required)

Yes

Please list the % of Free and Reduced Lunch students in your school(Required)

Contact Information

Teacher/Representative Name(Required)

First Last

What is your role?

Teacher

Parent

Administrator

Other

Mobile Phone(Required)

In case of emergency (i.e. cancellation), please enter the cell phone number for the attending teacher, chaperone, or parent.

E-mail(Required)

Enter Email Confirm Email

Information about your reservation and an invoice will be sent to this address

Will you be the person submitting payment?(Required)

Yes

Please enter the contact info for the person who will be submitting payment below:

Name(Required)