ASCYO Membership Information

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Please fill out this form completely and submit by Sunday, August 20th.

First Name (as you want it printed in the program) *

Nickname (if you go by a different name than above)

Middle Name

Last Name *

Which ensemble do you plan to be in? *

Prep Orchestra

Chamber Orchestra

Youth Orchestra

Concert Band

Unsure

Are you interested in playing in the Flute Choir (flute players only)?

Yes

Maybe

Clear selection

Which date do you prefer to audition? *

Tuesday, 8/22

Tuesday, 8/29

Doesn't matter

I can't do either date

Date of Birth *

YYYY

Pronouns (optional)

Primary Instrument *

Secondary Instrument

School *

Write "Home School" if you do not attend a public or private school

Grade in the 2023/24 School Year *

Street Address *

Apartment Number

City *

State *

Zip Code *

County *

Student Email (please do not provide a school email) *

Primary Student Phone *

Secondary Student Phone

Parent Name *

Second Parent Name

Primary Parent Email *

Secondary Parent Email

Primary Parent Phone *

Secondary Parent Phone

Private Teacher Name (if applicable)

Private Teacher Phone (if applicable)

Private Teacher Email (if applicable)

School Orchestra/Band Teacher Name (if applicable)

How did you hear about ASCYO? *

Friend

Teacher

Flyer

Social Media/Internet

Other:

Acknowledgment of Privacy Statement *

The Academy of Saint Cecilia Youth Orchestra (ASCYO) collects this information for the following purposes: 1. to administer the membership of the ASCYO; 2. to apply for grants and other sources of funding from federal, state, local and private sources; 3. to publish programs in support of ASCYO concerts. This information will not be shared with outside parties beyond these stated uses, and under no circumstances will an individual member's information be supplied to a third party without their prior consent; however by participating in the Academy of Saint Cecilia ensembles, you hereby authorize and consent to the publication of the member's name in materials intended for distribution in support of Orchestra concerts, including but not limited to programs, posters, and flyers.

I acknowledge and agree to the above Privacy Statement

Acknowledgement of Use of Personal Likeness Provision *

The Academy of Saint Cecilia Youth Orchestra (ASCYO) will display or publish photographs and images on its website, in newsletters, visual media and other publications to promote events, institutes, and other purposes which benefit ASCYO. Under no circumstances will an individual member's personal information be published in connection with a photograph or image without their prior consent; however by participating in the Academy of Saint Cecilia ensembles, you hereby authorize and consent to the display of the member's personal likeness, without compensation, on the website as well as in newsletters, visual media and other publications intended for viewing by or distribution to the public in support of ASCYO.

I acknowledge and agree to the above Use of Personal Likeness Provision

Acknowledgement of Email Notification Policy *

By providing an Email address above, the member is requesting information be provided by the Academy of Saint Cecilia Youth Orchestra through email. By providing an Email address for the parent, the owner of that email address is likewise requesting information be provided by the Academy of Saint Cecilia Youth Orchestra through email. Email addresses will be treated as private information subject to the above Privacy Statement.

I acknowledge and agree to the above Email Notification Policy

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