Embed Size (px)
Citation preview
OMAHA CONSERVATORY OF MUSIC 402.932.4978 7023 Cass Street Omaha NE 68132 STRINGSPROUTS.ORG
CELL HOME
WHAT IS STRING SPROUTS?
STRING SPROUTS APPLICATION FORM 2016-17
WITH
NEW STUDENT RETURNING STUDENT
CHILD’S GENDER:
TODAY’S DATE:
CHILD: (FIRST/LAST NAME)
AGE: DATE OF BIRTH: __/__/__PRIMARY CAREGIVER: (FIRST/LAST NAME)
DATE OF BIRTH: __/__/__ADDRESS:
CITY / STATE / ZIP:
EMAIL: PHONE:
ANNUAL HOUSEHOLD INCOME (CHECK ONE)
UNDER $20,000
$20,000-$49,999
$50,000-$59,999
$60,000-$79,999
$80,000-$99,999
$100,000+
# OF PEOPLE IN YOUR HOUSEHOLD:
# OF ADULTS (19+) IN YOUR HOUSEHOLD:
PREFERRED INSTRUMENT NEW STUDENTS ONLY, CIRCLE ONE
VIOLIN CELLO VIOLA
Measure for Violin or Viola!
Measure for Cello!
Please measure your child in inches from the neck to their left wrist. These measurements will be used to ensure a properly sized violin.
Please indicate your child’s height in inches to ensure a properly sized cello.
STUDENT ARM LENGTH:
STUDENT HEIGHT:
INCHES
INCHES
CLASS PREFERENCESee back for schedule options.
On back page, circle at least FOUR classes that work for your Sprout and Caregiver. You may circle as many as you want! This is a FREE 5-year program to learn violin, cello and
viola in a group setting from Pre-K through 3rd grade (you do not need to be a public school student!)
Instruments are provided at no cost for as long as you are enrolled in the program.
Each year contains 32 weeks of classes that run from September to June.
Potential Year 1 Sprouts must be 3 years old by July 15th and can be as old as 5 if not enrolling in Kindergarten in Fall 2016.
Caregivers must participate in the entire class each week and practice 10 minutes/day with your Sprout.
Sprouts perform in the spring with the Omaha Symphony!
LOCATION CLASS DAY CLASS TIME
OTHER
REASON FOR SELECTING CLASSES (CIRCLE ALL THAT APPLY):
SCHOOL:
RELATIONSHIP TO CHILD:
CAREGIVER’S GENDER:
ANYTHING ELSE WE SHOULD KNOW?
MEDICAL NOTES:
CHILD’S RACE / ETHNICITY PLEASE CHECK ALL THAT APPLY
AMERICAN INDIAN OR ALASKAN NATIVE
ASIAN
BLACK OR AFRICAN-AMERICAN
HISPANIC OR LATINO
NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER
WHITE
OTHER:
FREE
PROGRAM
INSTRUMENT
INCLUDED!OMAHA 6/21/16
Viola
Viola
Cello
Cello
Cello
Viola
OMAHA CONSERVATORY OF MUSIC 402.932.4978 7023 Cass St Omaha NE 68132 STRINGSPROUTS.ORG
STRING SPROUTS SCHEDULE 2016-17
BENSON WEST6652 Maple Street
KELLOM1311 North 24th Street
YMCA - DOWNTOWN430 S 20th Street
SALVATION ARMY KROC CENTER2825 Y St
OMAHA CLASSESMON TUE WED THUR
4:30 VIOLIN 15:30 VIOLIN 26:15 VIOLIN 3
4:30 VIOLIN 15:30 VIOLIN 26:15 VIOLIN 4
4:30 VIOLIN 2
5:15 VIOLA 1
4:30 VIOLIN 35:15 VIOLIN 1
4:30 VIOLIN 15:30 VIOLIN 2
4:30 VIOLIN 15:30 VIOLIN 2
4:30 VIOLIN 15:30 VIOLIN 3
4:30 VIOLIN 2
5:15 VIOLA 1
4:30 VIOLIN 15:30 VIOLIN 2
4:30 VIOLIN 15:30 VIOLIN 3
4:30 VIOLIN 15:30 VIOLIN 3
4:30 VIOLIN 15:30 VIOLIN 2
4:30 VIOLIN 25:15 VIOLIN 16:15 VIOLIN 4
4:30 VIOLIN 15:30 VIOLIN 3
OMAHA CONSERVATORY OF MUSIC 7023 Cass St
2:00 VIOLIN 14:30 VIOLIN 35:15 VIOLIN 4
4:30 VIOLA 1
2:00 CELLO 14:30 CELLO 25:15 CELLO 3
4:30 CELLO 15:30 CELLO 2
4:30 CELLO 15:30 CELLO 1
KELLOM EDUCARE2123 Paul Street
For information about Council Bluffs and Scottsbluff sites, please visit stringsprouts.org
Please circle at least FOUR classes that work for your Sprout and Caregiver. You may circle as many as you want! If you are a new student, select Level 1 classes.
