Student Center

Student Information Form

Student Name

Last First

Student Email

Student Phone

Address

Street City State Zip Code

Parent Name

Last First

Parent Email

Parent Phone

Parent #2 Name

Last First

Parent #2 Email

Parent #2 Phone

Ensemble

Cadet Strings
Youth Strings
Youth Winds
Youth Orchestra
Not sure.

Instrument(s)

Name of School

Grade

Do you play in your school's band?

Yes
No
My school doesn't have a band.

Do you play in your school's orchestra?

Yes
No
My school doesn't have an orchestra.

Number of years in WVYS

Private Teacher's Name

Last First

Private Teacher's Email

Private Teacher's Phone

I hereby give my permission for my child’s name and/or photograph to be released to newspapers, radio stations, television stations, or internet website for publicity purposes in conjunction with the WV Youth Symphony.

Yes
No

I would like to be included in the WVYS Directory.

Yes
No