Ensemble preference (you may choose more than one) Northern Iowa Youth Orchestra (grades 9 – 12) Fridays,5:00 - 7:00 p.m. Friday Northern Iowa Junior Orchestra (grades 5 – 8) Strings Only – 6-7:30 p.m. Friday Verismo Chamber Ensembles (grades 2 – 12) see scheduling preferences below SUMMER ORCHESTRA WORKSHOP (string players who have completed 7th-11th grades). sessions on August 15-19, 2023 at 5:00-6:30, Final concert at noon on Aug. 19. Student Last Name Student First Name Grade in School for fall 2023 Student Birthdate (required for ages 18 and under) Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year190019011902190319041905190619071908190919101911191219131914191519161917191819191920192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025 Instrument Family Email Additional Email All correspondence will be sent to the above email addresses. I give permission to share this email with other ensemble members. Yes No Phone #1 Phone Type Home Parent cell Student cell Phone #2 Phone Type 2 Home Parent cell Student cell Mailing address Street City Zip Parent or guardian name (adult applicants can put NA) Parent Type 1 Mother Father Other Parent or guardian name (adult applicants can put NA) Parent Type 2 Mother Father Other Private lessons I am currently taking lessons I am not currently taking lessons Teacher name Teacher Email Teacher Phone Comment School (put NA for adult applicants) Orchestra or Band Teacher (put NA if this does not apply) Current piece Title Composer Book Ensemble experience: Check as many as applicable. Northern Iowa Junior Orchestra Northern Iowa Youth Orchestra Verismo Honors or All-State Church or school small ensemble School orchestra or band Other... Ensemble experience: Check as many as applicable. Other... Required ONLY for Verismo ensemble scheduling My child is currently in a Verismo ensemble. Yes No Ensemble preference Stay with current ensemble Reassign to another ensemble First time member Scheduling optionsPlease indicate student’s availability for Verismo ensemble scheduling. Select as many options as possible. Monday 4:00 5:00 6:00 7:00 Wednesday 3:00 4:00 5:00 6:00 7:00 Thursday 4:00 5:00 7:00 Friday 4:00 7:00 Financial Obligation *I understand that my financial obligation to the UNI Suzuki School for participation in orchestra (NIJO, NIYO or CFCO) is for the activity term (September – December OR January -- April/May OR June – August). Should participation be discontinued mid-term, I agree to pay all fees in full. I understand that if I default on payments, participation privileges will be discontinued and my bad debt will be sent on to a collection agency for recovering fees due.I understand that my financial obligation to the UNI Suzuki School for participation in Verismo is for the full two terms (September - May). Should participation be discontinued mid-term, I agree to pay all fees in full. I understand that if I default on payments, participation privileges will be discontinued and my bad debt will be sent on to a collection agency for recovering fees due.Participation *I understand that participation in all sessions, rehearsals, recitals or concerts and tours, if offered, ensure the optimum success and progress.Photo Release *I understand that the UNI Suzuki School or agents may photograph and/or video/audio record any UNI Suzuki School function which my family may attend. I hereby grant UNI Suzuki School my permission to use such photos or videos for educational, historical or publicity purposes.Information Release *I understand that my contact information will be shared with the UNI Suzuki Association and other staff members. COMMENTS regarding potential orchestra rehearsal conflicts, Verismo scheduling or ensemble placement. Leave this field blank
