NJMEA/NJ Symphony Clinic Request Form
As a product of the partnership between NJMEA and New Jersey Symphony, teachers have the ability to complete the program request form and bring New Jersey Symphony musicians into their program to (1) guest conduct the ensemble through a clinic format or (2) sit in with the ensemble, play and provide feedback to student musicians.  The format is flexible based on the needs of the teacher and students, and is envisioned to promote student growth and interest, as well as provide professional development for the educator.  There is no cost to the teacher or school, as this is a membership service through the organizational partnership.  Sessions will be filled based on availability, total number of requests and the data supplied by the form.
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School name: *
Teacher's last name: *
Teacher's first name: *
Teacher's preferred email address: *
NJMEA membership number: *
Grade level(s) taught (check all that apply): *
Required
Ensemble(s) seeking support: *
Required
Desired time frame (please provide a list or range of dates, months, days of week, etc.)
Desired clinic time(s): *
Required
To the best of your knowledge, approximately how many times have you hosted guest speakers or musicians in the last five years? *
Is your district currently allowing in-person guests? *
If not, do you have the ability to host a guest virtually?
Clear selection
Optional - Please provide any other information that may assist in the scheduling of your clinic:
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