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NYSSMA INSTRUMENTAL REGISTRATION
Please fill out ONLY for Mr. Avellaneda. Deadline is February 22
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First Name
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Your answer
Last Name
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Your answer
Grade
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9
10
11
12
Date of Birth
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MM
/
DD
/
YYYY
Address
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Your answer
City
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Your answer
Home Phone #
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Cell Phone #
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Email that you check regularly
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I am registering for....
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Level 1-6 NON-All State
All-State (Level 6 Only)
All-State Jazz
Level
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1
2
3
4
5
6 NON-ALL STATE
6 (ALL STATE 10th & 11th Graders Only)
Instrument
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Piccolo
Flute
Oboe
Bassoon
Clarinet
Bass Clarinet
Horn
Trumpet
Trombone
Bass Trombone
Euphonium
Tuba
Percussion- Snare Drum
Percussion- Mallets
Percussion- Timpani
Piano
Alto Sax
Tenor Sax
Baritone Sax
Title of Solo
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Your answer
Composer
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Your answer
Page in NYSSMA Manual (located in office)
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Your answer
Check here if you will be submitting a special accommodations form
Check here, and then send Mr. A a SEPARATE EMAIL for the link to the form!
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