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Hazleton Area School District Instrumental Music Student Registration
Please complete the following information if you would like to join Instrumental Music lessons at your school.
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Email
*
Your email
Date
*
MM
/
DD
/
YYYY
Student Name
*
Your answer
Student Grade
*
Choose
4
5
6
7
8
Student School
*
Choose
Drums EMS
Freeland EMS
Hazleton EMS
Heights-Terrace EMS
Maple Manor EMS
McAdoo-Kelayres EMS
Valley EMS
West Hazleton EMS
What instrument are you interested in playing?
*
Choose
Flute
Oboe
Clarinet
Alto Saxophone
Trumpet
French Horn
Trombone
Baritone
Snare Drum
Bells
How do you plan on getting your instrument?
*
Choose
We will rent from Robert M Sides on line. (includes instrument, lesson book, and starter pack)
We will purchase an instrument from another source. (Will require the additional purchase of a lesson book and music starter pack.)
We have the instrument already. (Will require the additional purchase of a lesson book and music starter pack.)
We would like to borrow a school owned instrument if available. (Will require a loan contract from your director and a lesson book.)
Parent/Guardian Name
*
Your name will be considered as your signature.
Your answer
Parent/Guardian Address
*
Your answer
Parent/Guardian Home/Cell Phone Number
*
Your answer
Parent/Guardian Email Address
*
If no email available, type none.
Your answer
Please add my cell phone number to the Remind app, to receive notifications (text messages) regarding the school band program.
*
Yes, please add my cell number to the Remind list.
No, please do not add my cell number to the Remind list.
A copy of your responses will be emailed to the address you provided.
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