Tipitina's Internship Program - Audition Sign-up

Auditions will be held on MONDAY AUGUST 30, 2010, at North Rampart Community Center (the old St. Mark's) 1130 N. Rampart, corner of Gov. Nichols.

Audition time: 3:30 PM unless otherwise notified. While no previous musical experience is required, if the student does play an instrument, please bring the instrument to the audition and come ready to play.

A backline of piano, drums, bass and and guitar amp will be provided. If the child has no instrument, the program will attempt to provide one.

STUDENT Name *
Name of PARENT or Guardian *
HOME Phone
MOBILE Phone
WORK Phone
Home ADDRESS *
E-mail Address: *
Students E-MAIL address
OTHER E-mail or Phone
AGE of Student *
Any physical DISABILITY?	Yes No
Does the student CURRENTLY PLAY an instrument? *	Yes No
Does the student have his/her OWN instrument? *	Yes No
What INSTRUMENT does he/she play? *
Childs musical SKILL level *
Which SCHOOL is he/she attending? *
What TIME does school let out?
Current GRADE level *
TRANSPORTATION: How will he/she get to/from North Rampart Community Center *
Any PROBLEMS with transporation?
NOTES, comments or questions?


* Required

You will receive an email confirming this sign-up. If any question or concerns, please email todd@tipitinas.com or call (504) 309-7934

Tiptina's Foundation, Inc. http://tipsfoundation.org