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Region Clinic Registration

This document is a registration form for the Arkansas School Band and Orchestra Association's All-Region Clinic for Junior and Senior High students. It includes details such as the date, region, director's contact information, and fees for various bands. The form requires a list of participating students and their instruments, along with a certification of their eligibility by the director.

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gideon.garcia
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2 views1 page

Region Clinic Registration

This document is a registration form for the Arkansas School Band and Orchestra Association's All-Region Clinic for Junior and Senior High students. It includes details such as the date, region, director's contact information, and fees for various bands. The form requires a list of participating students and their instruments, along with a certification of their eligibility by the director.

Uploaded by

gideon.garcia
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Arkansas School Band and Orchestra Association

All-Region Clinic Registration/Certification


Junior and Senior High – Concert Band, Orchestra, Jazz Band

Date - 1.22.25 Region - 2 Director - Gideon Garcia


School - Centerpoint High School School Phone - (870) 356-3612
Email - gideon.garcia@goknights.us
____
X Concert Band ____ Senior High
____ Orchestra ____ Junior High
____ Jazz Band

Enclose for each student: $4.00 for Jr/Sr Concert Band; $7.00 for Orchestra; $14.00 for Jazz Band

Number of Students ____________


10 @ $ _______________
40 + $10 owed for Jazz
Amount Enclosed $ ________________
50

In order to participate, all fees must be paid in advance.

PLEASE PRINT OR TYPE – Please be very accurate with the spelling of names!
SEND COMPLETED TO HOST: DEADLINE FOR POSTMARK:

NAME INSTRUMENT NAME INSTRUMENT


1 Albania Ponce Flute 21
2 Brookelyn Standridge Clarinet 22
3 Kaitlyn Buck Clarinet 23
4 Aaliyah Hernandez Clarinet 24
5 Hailey Medina Alto Saxophone 25
6 Jaxon Lowery Bari Saxophone 26
7 Cesar Ortiz Trumpet 27
8 Nathan Stark Euphonium 28
9 Emmanuel Contreras Tuba 29
10 Kathy Esparza Percussion 30
11 Jazz Fee owed $10 31
12 32
13 33
14 34
15 35
16 36
17 37
18 38
19 39
20 40

We certify that we have checked the eligibility of the students listed, and that they are eligible to represent this school
under the rules of AAA and ASBOA.

__________________________________________ Updated 8/26/2024


Director’s Signature

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