Spring ChamberFlex Academy Registration Form

What are you enrolling for?*

STUDENT INFORMATION

STUDENT Name*

First Last

Student Email*

Student Cell Number*

If student does not have a cell phone then please put the main parent cell number.

Age as of Today*

Birthdate*

Grade (Spring 2024)*

School (Spring 2024)*

Instrument*

Number of years studied*

Private Instructor Name*

Private Instructor Email*

Please select all the student identifies as. This data is only used for grant/funding purposes.*

PARENT/GUARDIAN INFORMATION

Main Parent/Guardian Name*

This parent/guardian will be the Director of Education's main contact for the program.

First Last

Main Parent/Guardian Email*

Main Parent/Guardian Cell Phone*

Main Parent/Guardian Address*

Street Address Address Line 2 City State ZIP Code

Would you like to submit a second Parent/Guardian's information?*

Yes

Secondary Parent/Guardian Name*

First Last

Secondary Parent/Guardian Email

Secondary Parent/Guardian Cell Phone

Secondary Parent/Guardian Address

Same as main parent/guardian

Street Address Address Line 2 City State ZIP Code

ADDITIONAL INFORMATION

Is this the student's first time playing in a chamber ensemble? What other chamber music experience has the student had? (outside of ACMC)*

What repertoire (solos) and technical studies (etudes and scales) are the student currently working on? Provide specific pieces and/or books.*

The more we know about the student and their playing the better we can elevate their overall experience from putting ensembles together, to picking music, and to addressing individual differences and learning needs. Is there any additional information you'd like to share about the student enrolling? (optional)

Do your home have a piano that is available and accessible for rehearsals?*

The student's ensemble may or may not have a pianist but this will help if a pianist is placed in the ensemble.

Yes, I have an upright or grand piano

Yes, but it's a keyboard

Does your family have any concerns or limitations in regards to hosting rehearsals within your home or going into other homes for rehearsals?*

Ensembles are typically trios or quartets.

Please list the student's availability for rehearsals during the week (Monday-Friday) AND weekend (Saturday-Sunday). List the student's specific availability for all 7 days (ex. Monday 5-7pm, Tuesday 3-8pm, etc.)*

We understand that schedules change, but getting a general day to day idea of what your availability is helps us to pair students and a coach together more successfully.

List known dates the student CAN NOT rehearse during the above regular availability listed. Examples: If you are going out of town, school required events, college visits, etc.*

CONSENT

Parent(s)/Guardian(s) and Student grant permission to ACMC to use any photos and/or videos taken during the semester for non-commercial purposes.*

Mainly we use photos/videos to share with our families, patrons, funders, and for grant reporting.

PAYMENT

Spring Semester Tuition

Fee is non-refundable after January 9, 2024 for the spring semester.

Price: $500.00

Would you like to add a tax-deductible donation to support ACMC's education and outreach programs?

Total

Credit Card

Card Details

Cardholder Name

How did you hear about this program?*

Please check all that apply

Returning Student

ACMC Website

ACMC Email

School Music Teacher

Private Lesson Instructor

Other

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