Parent/Guardian Name *

First Name

Last Name

Phone

(###)

###

####

Student Name *

First Name

Last Name

How did you hear about ECCU? *

Student's music teacher

Social Media

Friend Referral

Google Search

Flyer

Other

Which of the following best describes your situation: *

We are in need of significant financial assistance to ensure my child's participation

We are in need of some financial assistance to ensure my child's participation

We are in need of no financial assistance to ensure my child's participation

Select which of the following options you will choose to submit your audition video. *

YouTube Link

Email