ONLINE REQUEST FOR INFORMATION

Please complete the following information to apply to any of the choirs.  After we receive your request for information, we will contact you to schedule an audition (for Treble, Ensemble, and Chamber) and answer any additional questions you have.  

Date

Child's Information

Child's Name (required)

Child's Age (required)

Child's Grade (required)

Child's Birthdate (required)

BoyGirl

Child Lives with:
Both parentsMomDadGuardianOther

Name of Child's School (required)

Does child study or has child studied a musical instrument? If so, what instrument(s)?

Number of Years
Name of Teacher

Parent/Guardian Information

Your Name (required)

Other Parent Name

Your Address (required)

Primary Contact Phone Number (required)

Primary Contact Email (required)

Additional Contact Phone Numbers

Additional Contact Emails

Should we include all these email addresses on communication from the administrative office?
yesnoother

May we distrbute these email addresses among choir families?
yesnoother

Emergency Contact Name (required)

Emergency Contact Phone Number (required)

Where did you find out about us?

Questions or Comments

Submission of this form indicates your acknowledgement of the statements below.

PLEASE NOTE: Parental involvement in the choir gives parents a sense of belonging and reinforces your child’s experience in the choir. All families are expected to contribute to the good health of the choir by volunteering (one volunteer job per parent) and attending the annual parent meeting. Upon your child’s acceptance to the program, you will be asked to indicate your preferences for volunteer activities.  These volunteer positions are filled on a first-come, first-served basis.

All classes take a certain amount of focus and attention. Some younger singers may not yet be fully ready to participate in the level appropriate for their age. Children are welcome to sit briefly and quietly with a parent in the younger levels until they are ready to participate again.

Online submission is not an entirely secure form of communication.  ​While Pacifica has made every effort to keep your information secure, we cannot be held responsible for any information that is intercepted.