BLMK Youth Orchestra Booking Form - The Bedfordshire Music Trust

BLMK Orchestra Application Form

Please enter the Parent/Carer/Contact details below

Parent/Carer/Contact Name

First Last

Parent/Carer/Contact email address

Emergency Mobile No

Alternative Emergency No

Home Phone No

Address

Street Address Address Line 2 City County Postcode

Please enter the Student details below

Student Name

First Last

Student Sex

Which other ensembles are you already in, if any?

Instrument

e.g. Violin

Standard (Grade equivalent)

Age

Date of Birth

School / College

Instrumental Teacher

How did you hear about us?

Do you have any medical conditions or additional learning needs?

Yes

Please let us know how we can support you on this course.

Are you happy for photographs/video being taken by BMT to be used solely for BMT marketing purposes?

Yes

Do you agree to receiving emails from us regarding this/future events?

Yes

Required for our Arts Council data returns

Which year group is the student currently in?

In which local authority is the school that your student attends?

Is the student registered as having special educational needs and/or a disability?

Is the student registered for Pupil Premium?

Student ethnic group?

WHITE/WHITE BRITISH

MIXED BACKGROUND

ASIAN/ASIAN BRITISH

BLACK/BLACK BRITISH

ANY OTHER ETHNIC GROUPS

I have read and accept the Terms & Conditions. Please note this data will be shared with the BLMK Hub for the purposes of planning the event.

Yes

Terms & Conditions

Clicking on the following button will send the above details to Bedfordshire Music Trust and you will receive an acknowledgement email.

BLMK Orchestra Application Form

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