Name *

First Name

Last Name

Phone *

(###)

###

####

Parent/Guardian Name *

If over 18, use this field for emergency contact.

First Name

Last Name

Parent/Guardian Phone *

(###)

###

####

Do you currently have access to your instrument(s)? *

Yes

No

What type of technology do you use at home? *

Check all that apply

Desktop (PC)

Desktop (Mac)

Desktop (Other)

Laptop (PC)

Laptop (Mac)

Laptop (Other)

iPad

Android tablet

Kindle or Nook

Chromebook

Smartphone

None

How do you access the Internet at home? *

Broadband (through a cable company hotspot)

DSL (through the phone company)

Dial‐Up (must connect via phone dial)

Cellular service

No Internet Access

Do you have access to headphones/earbuds? *

Yes

No

Do you have access to a microphone? *

Do you have a way to record yourself playing your instrument? (Choose the best quality available.)

Yes (Stand-alone microphone)

Yes (In headphones/earbuds)

Yes (On cell phone)

Yes (On laptop)

Yes (Webcam)

Yes (Other)

No

Do you have access to a camera? *

Do you have a way to record video of yourself? (Choose the best quality available.)

Yes (Stand-alone microphone)

Yes (Webcam)

Yes (On cell phone)

Yes (On laptop)

Yes (Other)

No

What social media/social networking sites do you use? *

Check all that apply.

Facebook

Twitter

Instagram

SnapChat

TikTok

WhatsApp

Skype

YouTube

LinkedIn

Discord

DeviantArt

ReverbNation

How would you rate your experience with the youth orchestra on a scale from 1 to 5? (1 being the lowest and 5 being the highest) *

1

2

3

4

5

Do you have supportive classmates?

Yes

No