2016 ROCmusic Application

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2017-2018 ROCmusic Application Form
Our program accepts students on a 'rolling-admission' basis and places applicants on our Waitlist for future contact -- Please keep in mind that every student must:
1. Apply     2. Interview with a parent/guardian    3. Attend our New Family/Student orientation     4. Sign our contract
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* Indicates required question
Email *
Your email
Applicant/Student Last Name: *
Your answer
Applicant/Student First Name: *
Your answer
Applicant/Student Gender: *
Applicant/Student Age: *
Your answer
Applicant/Student Date of Birth: *
Your answer
What grade in school (2017-2018) is your child? *
Does the applicant/student reside in the City of Rochester? *
Female Headed Household? *
City: *
Your answer
Apartment #:
Your answer
Applicant/Student Street Address: *
Your answer
Are you interested in participating in ROCmusic during the summer? *
ZIP Code: *
Your answer
Preferred Phone #: *
Your answer
Parent/Guardian Frist Name: *
Your answer
Please describe the Applicant/Student's type of school: *
Parent/Guardian Last Name: *
Your answer
Parent/Guardian Email: *
Your answer
School Name: *
Your answer
School #:
Your answer
Please pick your preferred ROCmusic Teaching Site: *
ROCmusic offers instruction during the school year in two City of Rochester Recreation Center locations: the Gantt R-Center (700 North Street), and the Edgerton R-Center (41 Backus Street). ***Lessons and Specials (drumming/choir/musicianship) take place for everyone on Wednesdays from 4-6pm at Gantt, transportation provided from Edgerton.
Music or Homeroom Teacher Name:
Your answer
What instrument does your child already play? And for how many years? *
Your answer
Please describe any previous musical training/experiences:
Your answer
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