Contact Information

Please complete this form and return to Mr. Householder

**ALL BAND MEMBERS MUST COMPLETE THIS FORM**

Student Name _________________________ Student Email __________________

Grade ________ Instrument _____________________

Parent Name(s) ___________________________ ______________________________

Home Address __________________________________________________________

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Home Phone # ___________________________________

Parent Cell Phone # ___________________________________

Student Cell Phone # ___________________________________

Work Phone # ___________________________________

Alternate Phone # ___________________________________

Parent Email(s) 1. ______________________________________________________

2. ______________________________________________________

3. ______________________________________________________

List of all school activities student is involved in:

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