Placement Interview Request

Fall 2010 Placement Interviews

Welcome! We're delighted that your singer is interested in the Piedmont Choirs.

Please fill in the brief form below, which will serve as your request to have your singer attend our next audition.

Do you already have a child in the Piedmont Choirs? If so, please login first, so that we may connect your information with this audition request.

Student's Name

First Name	*
Nick Name
Middle Name/Initial
Last Name	*
Gender
Date of Birth	Month Day Year *

Parent Contact Information

Parent First Name	*
Parent Last Name	*
Relationship to Singer	*
Email	* We will send a confirmation to this address.
Home Phone	( ) - - *
Mailing Address	*
City	*
State	*
Zipcode	*

How did you hear about the Piedmont Choirs?

How did you find out about Piedmont Choirs, and where have you seen Piedmont Choirs ads or other information out in the community? (please check as many as apply)

	Recommendation of current choir family Whom may we thank?
	Flyer brought home from school
Display ad or listing in:
	Alameda Journal
	Alameda Sun
	Alameda Times Star
	Bay Area Parent
	Berkeley Daily Planet
	Berkeley Voice
	Contra Costa Times
	East Bay Express
	El Cerrito Journal
	Lafayette Sun
	Montclarion
	Oakland Tribune
	Parents' Press
	Piedmonter
	Piedmont Post
	Rockridge News
	San Francisco Chronicle
	San Francisco Examiner
	Tri Valley Herald
	Other:
Flyer or brochure picked up in a public place: (where?)
Other: Please specify