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5th Grade Band and Orchestra Sign-Up Form
Contact Information: By filling out this form, you are signing up for the year long program.
In addition to completing this form, please print out the medical consent form (link below) and email to
barb.nelson@vansd.org
OR
libby.odren@vansd.org
. You may also turn it into your school office or mail to:
Barb Nelson/Libby Odren
JPC - Visual and Performing Arts
2901 Falk Rd, Vancouver, WA 98661
https://drive.google.com/file/d/15WUANriWRlRsBUh1FSRkBzcZKnN7knHD/view?usp=sharing
* Indicates required question
Student's Full Name:
*
Your answer
Parent/Guardian Name(s):
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Your answer
Current School:
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Your answer
Current Grade:
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Your answer
Email
Your answer
Home Address:
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Your answer
Best Contact Number:
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Your answer
Emergency Contact (other than parent):
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Your answer
Relationship to student:
*
Your answer
Requesting Class:
*
Band (Clarinet, Flute, Trombone, Trumpet)
Orchestra (Cello, Viola, Violin)
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