Enrichment Form

Bring Rockness Music to your school for musical programming that builds confidence, enables social interaction, and fosters a lifelong love of music

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Name of School/Establishment

Address of School/Establishment

Address Line 1

Address Line 2

City

State

Zip Code

Contact Person Name

Contact Phone

Contact Email

Numbers of groups/classrooms

Numbers of children per group/classroom

Preferred Day of the Week

Preferred Start Date and Time

Date

Time

Length of program (in weeks)

Age range of children

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