Plugged In Band Program · Songwriting and Production (cc)

How did you hear about Plugged In?

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Other

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How did you hear about Plugged In?

Student Information

Student Name

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First Name

Last Name

Gender

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Student Birthdate

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mm/dd/yyyy

Student Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Student Email

Verify Email

Student Home Phone

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Student Mobile Phone

School Name

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Current Grade

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Enter grade number only

Does the student have a family member participating in the Spring 2022 Songwriting and Production program?

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Yes

No

Parent Contact Information

Parent 1 Name (primary contact)

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First Name

Last Name

Parent 1 Primary Phone

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Parent 1 Email

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Verify Email

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Parent 1 Employer

Parent 2 Name

First Name

Last Name

Parent 2 Primary Phone

If different than parent 1

Parent 2 Email

Verify Email

Parent 2 Employer

Emergency Contact Information

Whom should we contact in case of an emergency? If registering for the youth program, please provide an alternate contact to the student's parents.

Emergency Contact Name

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First Name

Last Name

Emergency Contact Primary Phone

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Provide the most reliable number for this emergency contact

Additional Information

What is the primary device the student will be using to participate in class?

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Other

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Student's Primary Device

Does the student have any experience with songwriting?

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Songwriting experience is not required.

Does the student have any experience with digital audio production?

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Digital audio production experience is not required.

If the student plays an instrument, what is the their main instrument?

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Playing an instrument is not required. Students can create music with an instrument or will be taught how to create music digitally.

What style of music does the student prefer most?

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Other

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What style of music does the student prefer most?

In order for the student to have the best possible experience at Plugged In, we strongly encourage you to share information regarding medical conditions, special needs, behavioral and emotional concerns, allergies, etc.

PLEASE CHECK ALL THAT APPLY - (Information regarding a student may be shared with the Plugged In Directors and their teacher, and will otherwise remain confidential.) .

Autism Spectrum Disorder (ASD)

Attention Deficit Disorder / Hyperactivity Disorder (ADD/ADHD)

Depression

Anxiety / Social Anxiety

Allergies

Physical Limitation

Other

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Please identify and describe the student's condition.

Would you like to be contacted by the Plugged In Inclusion Committee?

Plugged In is a fully inclusive program. The Plugged In Inclusion Committee works with students/families that may need additional supports to ensure their best possible experience.

Yes

No

Please share any additional information that would help with band placement.

Ex: prefers to be with older students, prefers to be with low-key performers, etc.

Please share any information that would be important for the band teacher to know in working with the student.

Ex: student excels in structured environment, student requires breaks, student is shy, etc.

Showcase

Plugged In holds a benefit concert at the end of every program session. For our online programs, this event is a livestream showcases of student projects. In addition to presenting their projects and performances, the benefit concerts and showcases also give students a unique opportunity to give back to the community. Each benefit concert and showcase raises funds and awareness for a charity chosen by the students at our Community Engage event that will be held this session (exact date TBA). The concerts and showcases show students they can make positive change in the lives of others by doing something they love, like playing music.

The Spring Session Benefit Concert and Showcase will be June 16-18, 2022.

Showcase Scheduling

We do not accept showcase scheduling requests. All students must be able to perform when scheduled.

As Plugged In continues to grow so have our benefit concerts. To accommodate our growing community the concert format and scheduling policy required updating. We've done so in a way that allows us to craft a stellar show that gives our students, audience, and the charity benefiting from the concert the best possible experience. In addition to creating a better performance experience for everyone, the new policy also allows us to be more thoughtful when scheduling younger students and those with special needs. Finally the new policy will reduce the overall time students are required to be at the show, lessening the scheduling burden on families. Although, we hope you'll enjoy the performances so much you'll stay for the entire show!

Would the student like to get information about joining our Youth Board?

Yes

No

Are you (the parent) interested in volunteering at Plugged In?

Parent volunteers provide support in all areas of Plugged In and are crucial to our continued success. Opportunities include joining our Board of Directors or sub-committees, helping with performance set-up and breakdown, marketing, and more.

Yes

No

Parent Volunteer Tasks

Please check all that apply

Marketing (hanging up flyers, community emails, social media, etc.)

Performance Production (transporting, setting up, and breaking down equipment, live sound)

Plugged In Board of Directors

Plugged In Committee(s) (Facilities, Finance, Inclusion, Development, etc.)

Parent Volunteer Skills

Do you have a particular skill that you would like to volunteer? ex: graphic design, book keeping, event planning, etc.

I'd like to be contacted about private instruction at Plugged In.

For more information about private instruction visit www.pluggedinband.org/programs/private-lessons

Yes

No

Policy

To participate in Plugged In you must read, understand, and agree to the following policies. If you have questions regarding any of the following policies please contact Plugged In directly.