| Returning Member: |
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| Did you participate in the Spring 2010 semester with the CVYO? |
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| In which orchestra did you participate? |
Strings Prep Youth Harp Percussion |
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| Student's First Name: |
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| Student's Middle Name or Initial: |
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| Student's Last Name: |
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| Instrument: |
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| Private Music Teacher's Name: |
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| During the upcoming 2010/ 2011 School Year: |
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| What School will you attend?: |
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| What Grade level will you attend?: |
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| Student's home address: |
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| City: |
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| State: |
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| Zip Code: |
(5 digits) |
| Home Phone Number ( include Area Code ): |
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| Mother's Full Name: |
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| Mother's Cell Phone: |
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| Father's Full Name: |
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| Father's Cell Phone: |
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Parent's email address: ( main email )
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| Student's email address: |
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| Special Comments: |
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Take a moment to double check you responses before pressing " Submit "
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In a few days you will receive an email confirming our having
received this transmission. If you do not receive a confirmation
via email in a few days, or if you have any questions please
contact us at: 805 523-8045
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