PYO Registration
New and returning members of PYO, PCSO, & PJSO please complete this form each SEASON.  If you are participating in multiple sessions (there are 3 sessions per season) you only need to complete it the first session in which you participate, however if you have any changes to your contact information though out the year please send notification to music@pocono-youth-orchestra.org.  Members and their families are also always welcome to use this email address to contact PYO with any questions or concerns.  Please see www.pocono-youth-orchestra.org for Handbook, Calendar, Remind Sign-up, and more.
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Student LAST Name *
Student FIRST Name *
Age *
Student Grade in School  *
Student Email *
 (or email to receive rehearsal notes)
Address *
 House Number, Street, City, State, & Zip Code
Main instrument to be played in orchestra  *
Other instruments student plays
Student’s School *
School Music Director *
Private Music Teacher
Private Music Teacher Phone Number
Private Music Teacher Email Address
PRIMARY CONTACT *
Parent or Guardian Name, First and Last
Primary Contact Phone Number *
Primary Contact Email *
SECONDARY CONTACT:
Parent or Guardian Name, First and Last [Optional]
Secondary Contact Phone Number
[Optional]
Secondary Contact Email
[Optional]
REFERRAL:  [If Applicable]
 *NEW MEMBERS ONLY* 
Please give the name of the current orchestra member who referred you to join so they may receive a $20 tuition credit. (please see PYO Student Handbook for limitations and exclusions)
Orchestra Level *
 (as determined by your audition placement)
Required
I plan to participate in the following sessions: *
Select all that apply.  Please see website calendar for specific dates at www.pocono-youth-orchestra.org.
Required
Form of Payment: *
PLEASE NOTE:  
  • PYSO/PYO is $135 per session or $405 for all 3 sessions/entire season; 
  • PCSO and PJSO are $110 per session or $330 for all 3 sessions/entire season.
Paypal Email: 
If you have chosen the Paypal option for tuition payment please indicate the email address associated with your paypal account so we may properly apply your payment. It would also be helpful if you can add student member’s name in note when making payment, thank you!
Tuition Payment Selection:  I will pay…
  • PYSO/PYO is $135 per session or $405 for all 3 sessions; 
  • PCSO and PJSO are $110 per session or $330 for all 3 sessions.
  • Payment is due no later than the first rehearsal of each session.
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Media Agreement: *
Do you agree and concent to the following Photography, Video, and Audio agreement?
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STUDENT/MEMBER SIGNATURE: *
By entering my NAME in the space below, I agree to abide by the rules and policies specified in the PYO Student Handbook.  (Handbook is available at www.pocono-youth-orchestra.org)
PARENT/GUARDIAN SIGNATURE: *
By entering my NAME and TODAY’S DATE in the space below, I certify that the information entered above is true and accurate.
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