THE DEADLINE FOR APPLIATIONS IS FRIDAY 21 OTOER

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Transcript of THE DEADLINE FOR APPLIATIONS IS FRIDAY 21 OTOER

THE DEADLINE FOR APPLICATIONS IS FRIDAY 21 OCTOBER

PLEASE RETURN THE FORM TO:

EMAIL [email protected]

POST LEWISHAM MUSIC SERVICE, 3RD FLOOR LAURENCE HOUSE, CATFORD, SE6 4RU

PLEASE CONTACT LEWISHAM MUSIC SERVICE ON 020 8314 3813 TO ARRANGE PAYMENT

PLACES ARE LIMITED AND WILL BE ALLOCATED ON A FIRST COME FIRST SERVED BASIS

LEWISHAM JUNIOR ORCHESTRA

THURSDAY 27 OCTOBER

CHILD’S NAME DATE OF BIRTH GENDER

MALE / FEMALE

CURRENT SCHOOL CURRENT YEAR

GROUP HOME ADDRESS

POSTCODE

PARENT/CARER NAME EMAIL ADDRESS

HOME TELEPHONE NUMBER MOBILE TELEPHONE NUMBER

EMERGENCY CONTACT NAME

(IF PARENT/CARER NOT AVAILABLE) EMERGENCY CONTACT NUMBER

IS YOUR CHILD A LOOKED AFTER CHILD (IN CARE)? DOES THE CHILD RECEIVE FREE SCHOOL MEALS?

YES / NO YES / NO

DOES YOUR CHILD HAVE ANY MEDICAL

CONDITIONS? DOES YOUR CHILD HAVE ANY SPECIAL NEEDS?

YES / NO YES / NO

IF YES, PLEASE GIVE DETAILS:

IF YES, PLEASE GIVE DETAILS:

WHAT IS YOUR CHILD’S ETHNIC ORIGIN?

DO YOU GIVE CONSENT FOR PHOTOS OR VIDEOS OF

YOUR CHILD TO BE TAKEN AND USED FOR THE PURPOSES

OF PUBLICITY, NOW AND IN THE FUTURE?

YES / NO

DO YOU GIVE PERMISSION FOR YOUR CHILD TO LEAVE THE LEWISHAM JUNIOR ORCHESTRA UNACCOMPANIED?

YES / NO

WHAT INSTRUMENT DOES YOUR CHILD PLAY? WHAT GRADE/LEVEL IS YOUR CHILD?

1 / 2-4 / 4-5 / 5+