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Lyric Theatre's KIDS' CLUBHOUSE request form
Have Professor Matt and Gertie come perform at your school!
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* Indicates required question
What is your preferred semester?
*
Fall
Spring
Preferred number of performances:
*
Your answer
List the earliest time of day your school can accommodate a 45-minute performance (e.g. 8:45 AM):
*
Your answer
List the latest time of day your school can accommodate a 45-minute performance (e.g. 1:30 PM):
*
Your answer
When is your school's lunch period?
*
Your answer
List any dates your school CANNOT host an interactive performance (i.e. breaks, testing, etc.)
*
Your answer
Name of School:
*
Your answer
Address 1:
*
Your answer
County
*
Your answer
Contact 1 Name, Email, Phone #
*
Your answer
Contact 2 Name, Email, Phone #
*
Your answer
Performance Venue (classroom, gym, cafetorium, etc.):
*
Your answer
Expected Student Attendance:
*
Your answer
Youngest Grade Level Expected to Attend:
*
Your answer
Oldest Grade Level Expected to Attend:
*
Your answer
Are You a Title 1 School?
*
Yes
No
Percentage of Students on Free/Reduced Lunch Program:
*
Your answer
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