Name                                                                                          Phone                                                    

Address                                                                                      City & Zip                                                

Instrument(s)                                                                               Email                                                     

 1. Current Ensemble and Orchestra Involvement

 2. Past Ensemble and Orchestra Experience  (How long?)

 3. Current Involvement in Music Education, Teaching, or Working with Youths (not a requirement)

 4. Past Experience in Music Education, Teaching, or Working with Youths (not a requirement)

I understand that the purpose of the orchestra is to work with youth, ages 12 through 18, as a mentor and coach

during the rehearsals. I also understand that the scope of the program arranged and supervised by Pontiac Bay

Symphony Orchestra consists of the scheduled rehearsals, sectionals, and concerts. The rehearsals are also open
to the parents of the youth participants. Pontiac Bay Symphony Orchestra has not arranged or approved any other

activities for the participants beyond the rehearsals and concerts. However, Pontiac Bay Symphony Orchestra does
facilitate phone and email communication among all participants during the course of the orchestra program as a way
to communicate orchestra news, information, and activities, and prepare for the rehearsals and concerts.

 Signature                                                                                       Date

 Please mail application to:   PBSO, P.O. Box 27307, Seattle, WA 98165-1807