Placement Interview Request

Welcome! We're delighted that your singer is interested in the Piedmont East Bay Children's Choir. Placement interviews will be held on September 10th, or by appointment. Please fill out the brief form below to schedule a placement interview.

Please call us at 510-547-4441 if you have questions about our programs. We look forward to speaking with you!

Student Information

First Name*

Last Name*

DOB*:

Gender:

School:

Grade*:

Music Experience (singing/piano/musical theater/other instruments/etc.):

Parent/Guardian Information

Primary Parent/Guardian

First Name*:			Last Name*:			Relationship to Student*:

Email*:

Phone*:

Address			City			State			Zip

Secondary Parent/Guardian

First Name:			Last Name:			Relationship to Student:

Phone

Address			City			State			Zip

How did you hear about us*?