HPS Educator Program Space Reservation

Participant Name*

First Name

Last Name

Invitation Number (If Available)

School or Studio Name*

Title (i.e. "Choir Director" or "Private Instructor")*

Email Address*

Please note: Since a majority of program communications take place via email, it is critical you add honors@honorsperformance.org to your list of approved senders.

Cell Phone Number*

Work or Home Phone Number

I live in...*

The United States Canada Other

Please note that all program communications to participants outside the US/Canada are sent electronically. To ensure you receive important program details and communications, please ensure that honors@honorsperformance.org is added to your list of approved senders with your email provider.

School or Work Mailing Address*

Address Line 1

Address Line 2

City

Province

Postal Code

Country

School or Work Mailing Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Country

Gender*

Male Female

Date of Birth*

Primary Educational Focus*

Vocal Instrumental

Please indicate the grade level(s) you teach (in school or for private lessons)

Elementary School Middle School High School University

Other:

Other could include multiple levels. If so, please note which levels.

Registration Deposit & Program Payment*

I intend to personally finance my participation. I intend to work with my school to pay for this program.

Other:

Please note: Your space in the program will not be secured until your registration deposit has been received.

We recognize that educators may be interested in participating with the Series in multiple ways. If you are considering applying as a Chaperone for the June Middle School Series at Carnegie Hall, please indicate so below. Any Educator Program participant who is later selected as a Chaperone will receive a full refund of any monies paid for your Educator Program participation.

I will be applying as a chaperone. I am considering applying as a chaperone. I am not planning to apply as a chaperone.

Other:

I certify that I am at least 22 years of age. I certify that I have read, understand, and agree to the Honors Performance Series Participant Release and Binding Arbitration Agreement, as well as the Educator Program Terms and Conditions, provided below.

Please note that each participant must register individually.