Participant Information
Name
Grade (This Fall)
Mailing Address
City		State	Zip
Phone
School (Fall)
Parent's Name(s)
Email
Instructor 1
Email
Instructor 2
Email
Are you a returning camp member?
Are you a bringing your own marimba?
Do you have a disability for which you will require accommodations under the terms of the American With Disabilities Act?
Marimba Repertoire Studied/Performed
Solo Title 1
Solo Title 2
Solo Title 3
Solo Title 4
Solo Title 5
Registration Information
Tuition Status
Seminar Shirt ($12 ea.)
Seminar T-Shirt Size (if applicable)
Additional Shirt Request(s)
LHS Concert Ticket Request
Total Due	$
Less Deposit $125 (non-transferable)	-$
Balance Due at Registration	$

Upon submitting your LHS High School SMS Online Registration Form, a verification notice
outlining your information will follow. Print at that point for your records if you wish.

Please mail deposit fee check of $125 payable to: Plano Band Boosters.
Registration deadline is June 8, 2012.
Plano Senior High School Band/Attn Michael A. Hernandez, 2200 Independence Parkway, Plano, TX 75075

Questions or concerns? Please contact Michael A. Hernandez, 972.345.0598 (michael@drop6.com or michael.hernandez@pisd.edu) FAX: 469.752.9301