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Student First Name*

Student Last Name*

Student Email*

Student Phone Number*

Instrument*

#Years Played*

Audition Method*

Live

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Audition Date*

Audition Time*

Time

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Lessons*

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#Years Taken*

Teacher/Mentor*

Part of School Music Program*

Yes

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School Group/Program*

School Grade*

Member CSYSA Prior Season*

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CSYSA Group*

Shirt Size*

Referred by CURRENT Student - Enter Name

Interested in Chamber Music Ensemble

Kathy Loo Center for the Arts - 3113 Primrose Dr, Colorado Springs, CO 80907

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