June 16, 2014

Dear Parent,

Congratulations on your child’s successful audition! This promises to be an incredibly exciting year as we celebrate 81 years with our new name, Eugene-Springfield Youth Orchestras! Please follow the guidelines listed below to complete the registration.

1. Download the entire registration package, 11 pages total (you must have Adobe Reader).

2. Fill out the membership form (page 1), musician agreement (page 3), eligibility form (page 4), program fee/payment options (page 5), financial aid form (page 6, if you are applying for any scholarship), lesson scholarship student form and teacher form (page 7 & 8, if applicable), instrument rental agreement (page 9, if applicable)

3. RETURN FORMS BY JULY 15 by mail to: ESYO, PO Box 5666, Eugene, OR 97405. In person: M-Th: 9am-1pm and 2-5pm Fri: 9am-12:30pm 3411 Willamette Street (in the back of the Dunn School next to the Post Office.)

Registration is not complete until all forms are returned with your payment and/or payment agreement (pages 5 & 6)

Completed Eligibility Forms and Exemption Applications (page 3) that require school personnel signatures, must be returned by Sept. 16 (prior to the first orchestra rehearsal). Committee review of Exemption Applications will begin Sept. 17. Since there will be few exemptions granted, it is highly recommended that students get their school schedules arranged early, to include school band/orchestra classes.

If you cannot download the registration package, or if you have any questions, please contact the our office at 541-484-0473 at office@ESYOrchestras.org.

Once again, congratulations to your student!

EUGENE–SPRINGFIELD

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Musician’s Information PLEASE PRINT CLEARLYName (Last, First):________________________________________ Student’s Email: ______________________________________

Mailing Address: _______________________________________________________________________________________________ (City) (State) (Zip)Home Phone: (_____)_______________ Cell Phone: (_____) _________________

Male ____ Female ____ Birth Date: ___/___/___ (mm/dd/yy)

School in September 2014: ____________________________________________Grade in September 2014:____

School band/orchestra teacher name: ________________________ Name of school band/orchestra class: ___________________

Instrument: ______________________ Years Played _____ Play another instrument? How long?__________________________

Current Private Music Instructor: ________________________________ Private Instructor’s phone number:________________

Private Instructor’s email: ___________________________________

Private Instructor’s mailing address: ____________________________________________________________________________

YS and JO members – Are you interested in participating in AMP (Ambassador Musicians Program? Yes ____ No ____(*Students can earn community service hours by participating in AMP).

Parent 1 Information Name (Last, First):______________________________________ Email: _____________________________________________

Mailing Address(if different): __________________________________________________(City)_________(State)______(Zip)_______ Home Phone: (_____)_______________ Work Phone: (_____) _________________ Cell Phone: (_____) _________________

Employer: ____________________________________ Position: __________________________________

Primary contact for musician? Yes ____ No ____

Preferred contact method (some updated news or reminders may only be available through email): Email ___ Mail ____ Phone ____

Preferred Language: English ______ Spanish _____ Other(please specify):_____________

Parent 2 Information Name (Last, First,):_______________________________________ Email: ____________________________________________

Mailing Address(if different): __________________________________________________(City)_________(State)______(Zip)_______

Home Phone: (_____)_______________ Work Phone: (_____) _________________ Cell Phone: (_____) _________________

Employer: ____________________________________ Position: __________________________________

Primary contact for musician? Yes ____ No ____

Preferred contact method (some updated news or reminders may only be available through email): Email ___ Mail ____ Phone ____

Preferred Language: English ______ Spanish _____ Other(please specify):_____________

For office use only: QB____ Access____ Attendance Roster____ Copy to ED with FAA ____ Copy to ED with PLS ____

Membership Form (due by July 15, 2014) YS ___ JO ___ LS ___ SA 2 ___ SA1 ___

EUGENE–SPRINGFIELD

Orchestra policies

AttendanceAll orchestra members have to attend scheduled rehearsals and performancesExcused absences: If there is personal illness or family emergency, it is considered as an excused absence.Who to call: In case of personal illness or family emergency, the parent is required to call the ESYO

Attendance Phone at 541-505-2744Absence Request form: If there are any other reasons why a musician must be absent from the rehearsal, an Absence

Request Form must be completed and given to your conductor at least 10 days prior to the

absence.Tardies: Three unexcused tardies per concert set will be counted as one unexcused absence. Conductor

and registrar will determine if a tardy is unexcused.Unexcused absence: Absence without calling the Attendance Phone or submitting an Absence Request Form is

considered an unexcused absence.Each member will be permitted only one unexcused absence per concert set. Dismissal from the orchestra can result from

violating the attendance policy.

Rehearsal ScheduleYouth Symphony: every Monday, 6:45pm to 9pm, South Eugene HS Band/Orchestra RoomJunior Orchestra: every Monday, 6:45pm to 8:45pm, Roosevelt MS Band/Orchestra RoomLittle Symphony : every Monday, 4pm to 5:30pm, Roosevelt MS Band/Orchestra RoomSpecific rehearsal dates, concert dates, meeting dates will be located on the Calendar Page of our new website,www.ESYOrchestras.org beginning July 1.

Program fee and refunds(1) Students who have an outstanding balance will not be allowed to register for next year’s programs.(2) Payment plans will be extended to families who have honored past payment plans.(3) Accounts must be current until paid in full by 9.15.14 (if on payment plan) or student may be dropped from

orchestra. (4) Full program fee will not be refunded unless the orchestra/class has been cancelled by ESYO.(5) Students who elect to drop out will receive a maximum 50% refund if his/her participation is less than 3 months. A

petition for refund is required. (6) Students who are unable to attend rehearsals/class due to a long term (4 consecutive weeks or more) physical

condition with a doctor’s note will receive a prorated refund for missed activities. (7) Any petitions for refunds will be reviewed by the ESYO Executive Board. Decisions made by the ESYO Executive

Board are final.

Cancelled Classes(1) Information concerning cancellation of rehearsals, concerts or classes can be obtained by calling the ESYO office at

541-484-0473 or on our website www.ESYOrchestras.org(2) All ESYO activities will be cancelled if the Eugene 4j Schools are closed due to inclement weather or school safety

considerations. (3) ESYO reserves the right to modify a class due to insufficient enrollment, instrumentation or extenuating

circumstances.

Musician Agreement (due by July 15, 2014)

RELEASE FROM LIABILITY AGREEMENT

In consideration of the right to participate in ESYO’s activities, I release any and all claims for damages and losses suffered by me or my minor child against ESYO and any officers or agents thereof. I further understand that there are certain risks inherent in this activity and that proper training and physical conditioning is necessary. I hereby agree to assume those risks on my behalf or on the behalf of my minor child and to hold harmless ESYO and its agents. I have read and understand the above.

I have read and understand the above agreement and also the ESYO orchestra policies on page 2 of the registration package.

Musician Name (Last, First): ____________________________________________________

Signature of Student/Musician: ____________________________ Date: ___________

Signature of Parent or Legal Guardian: ______________________ Date: ___________

PHOTO RELEASE

I give permission for use of my child’s photo for newsletter, web site or other marketing purposes taken during ESYO classes, rehearsals or performances. I do NOT authorize use of my child’s photo for any reason.

Signature of Parent or Legal Guardian: ______________________ Date: ___________

For office use only:Non authorization copy to ED _____

Eligibility Form and Exemption Application 2014-2015 (due by Sept. 15, 2014)

All students in the sixth grade or higher, who are members of the Youth Symphony, the Junior Orchestra, the Little Symphony or String Academy 2, are required to play the instrument they play in their ESYO ensemble in their respective school or state-accredited private school bands or orchestras for the ENTIRE school year. This requirement was created to maintain a cooperative and supportive relationship between the public and state-accredited private school music programs and ESYO. There are a limited number of exemptions which may justify your inability to successfully meet this requirement.

YS___ __ JO_____ LS_____ SA2_____ Date: ______________

Musician Name (Last, First): _______________________________Musician Signature:_____________________

Current School _______________________________ Grade _________ Instrument_______________________

Please √ the appropriate box that applies to your eligibility and complete corresponding sections.

_____ I am currently enrolled in my school’s band/orchestra class.

Name of school band/orchestra Teacher _____________________________________________________

Name of school band/orchestra class__________________________________________________________

_____ The school I attend does not have band or orchestra as a part of its regular curriculum. School counselor signature: ___________________________________________________________________ I am home schooled and cannot be a member of a school band or orchestra.

Parent or guardian signature: __________________________________________________________________ I am a high school junior or senior and am unable to enroll in my school band or orchestra because the band

or orchestra class conflicts with another class offered at the same time that is required for graduation. This exemption request will go to ESYO committee for review.

Briefly describe the conflict:______________________________________________________________

_____________________________________________________________________________________

School counselor signature: ______________________________________________________________

School band/orchestra teacher signature: ___________________________________________________

_____ I am unable to enroll in my school band or orchestra due to reasons other than those listed above. This exemption request will go to ESYO committee for review.

Briefly describe the conflict:______________________________________________________________

_____________________________________________________________________________________

School band/orchestra teacher signature: ___________________________________________________

For office use only: ESYO Committee: Approve ____________Not Approved ____________(recommended action) ______________________\ Copy to ED _____

YOUTH SYMPHONY PROGRAM FEE & PAYMENT OPTIONS (due by July 15, 2014)

Musician Name: ______________________________________________________________________________ Last First

□ Youth Symphony registration fee - $445

We are offering a multi-family member discount. The first family member pays full registration fee, but if this student is the second or subsequent family member registering for any ESYO orchestra, please choose the multi-family discount option.

□ Multi-family member discount for Youth Symphony - $425

__ Check or money order enclosed (payable to ESYO)

__ Visa/Master card number:____________________________ Exp. Date:__________

Cardholder name (print): ________________________________________________

Amount Authorized: _________________________

Authorized Signature: __________________________________________________

__ I agree to settle the program fee by the following payment plan.

Youth Symphony payment plan$225 with registration$110 by 8.15.2014$110 by 9.15.2014 (multi family member - $90 due 9.15.2104)

**Signature of parent or legal guardian: ________________________ Date: _________

__ I have included a completed financial aid form. I agree to settle the balance within two months after the financial aid decision is made and no later than 9.30.2014

**Signature of parent or legal guardian: ________________________ Date: _________

For office use only:

QB_______ check #_____________ amount______________ cash________ CC___________

EUGENE–SPRINGFIELD

Financial aid and private lesson scholarship form (due by July 15, 2014)

(Due to the availability of funding, the award of one scholarship does not guarantee the award of another)

Check all that apply:

___ I’d like to apply for a program fee scholarship.

___ I’d like to apply for an instrument rental scholarship.(applicable to students who rent instruments from ESYO only)

___ I’d like to apply for a private lesson scholarship (applicable to YS/JO/LS/SA 2 only) • a separate student form is required (pg. 8) • if the student took private lessons in the past, an evaluation form from the private teacher is also required (pg. 9) • recipient will be awarded $20 per lesson, maximum 1 lesson per week/4 per month from

August 2014-June 2015.

MONTHLY FAMILY INCOME INFORMATION (CONFIDENTIAL)List the names of all household members who have income and their monthly earnings (before deductions).

Name (last, first) Age Monthly Earnings(Before Deductions)

Other Income(Welfare, Child Support, Social Security, Alimony, Retirement, Unemployment, Food stamps, etc.)

1.

2.

3.

4.

TOTAL HOUSEHOLD MEMBERS: _____ TOTAL MONTHLY INCOME (Before Deductions) $ ____________

DECLARATION • I agree to settle the balance within two months after the financial aid decision is made and no later than 9.30.2014 if a scholarship is not

granted.• I understand that ESYO reserves the right to request additional supporting document(s) to verify the above-stated income. • I understand that my child’s past attendance in ESYO classes/camps and any late payment record may affect the granting of this program fee

scholarship. • I understand that this information must be accurate and that the information is given for the single purpose of determining qualifications

for awarding an ESYO Scholarship. Deliberate misrepresentation of the information may result in the denial of this request.

Musician Name (Last, First): ________________________________________________________________________

Signature of Parent or Legal Guardian: ______________________________________________Date: ____________

For office use only: _________% of ESYO guideline ______________________________________ (ESYO Official)

_____ Approved PFS _____ Denied PFS $_________ amount of PFS $_________Amount of parent portion _____ Approved IFS _____ Denied IFS $_________ amount of IFS $_________Amount of parent portion _____Private Lesson Scholarship Financial Evaluation Score ________Private Lesson Scholarship Score _____ Approved Lesson Scholarship _____ Denied Lesson Scholarship Copy to ED with FAA _____ Copy to ED with PLS _____

Private Lesson Scholarship Student Application Form (due by July 15, 2014)(Turn in with page 9 of registration packet, if applicable)

(1) How often do you practice?___ Once a week ___ Twice a week ___ Three to four times a week___ Five to six times a week ___ Everyday___ Irregular, depending on schedule

(2) Usually, how long is each practice?___ about 15 minutes ___ about 30 minutes___ between 30 minutes and an hour ___ more than an hour

(3) Have you taken private lessons before? ____Yes ___ NoHow frequent are your lessons?___ once a week ___ twice a week ___every other week___ irregular, depending on teacher and my availability

(4) Usually, how long is each private lesson?___ 30 minutes ___ 45 minutes ___ 60 minutes ___ Other (please specify): ______________________

(5) Tell us the thing(s) that you usually work on during individual practice.

(6) What have you learned or improved upon from your private lessons?

I understand that this information must be accurate and that the information is given for the single purpose of determining qualifications for awarding a Private Lesson Scholarship.

Musician Name (Last, First): ________________________________________________________________ Musician Signature: _______________________________________________ Date: ______________

For office use only: copy for ED_____ Student Evaluation Scores __________/__________/__________/__________/__________ Total ________

Private Lesson Scholarship Teacher-Student Evaluation Form

(due by July 15, 2014)

Dear Music Teacher:

Your student is applying for a Private Lesson Scholarship from Eugene-Springfield Youth Orchestras. We are including a teacher evaluation form, so we have a better understanding of a student’s past private lesson performance.

Please note that this form will remain confidential, and will not be shared with anyone outside of the ESYO Lesson Scholarship Committee. After your complete this form, please put it into a sealed envelope for confidentiality. Please sign across the sealed area and have your student submit it to Eugene-Springfield Youth Orchestras. Thank you for your assistance with our Lesson Scholarship Program!

Student name (Last, First): _______________________________________________________

Please rate the following:Excellent Good Fair

Lesson Attendance

Lesson Participation(Focus, Attentiveness, Attitude)Practices Regularly

Progresses Acceptably Each Week

Please include any notes to clarify above marks (i.e. – “fair” lesson attendance was the fault of the parent rather than the child, “excellent” practice refers to everyday practice or a long practice every two days, etc):

Please comment on the improvement that this student has made in the last year?

Music Teacher Name: ___________________________________________________ Music Teacher Signature: ____________________________ Date: ______________

For office use only: copy for ED_____ Teacher Evaluation Scores __________/__________/__________/__________/__________ Total ________

Registration package – page 9

Eugene-Springfield Youth OrchestrasP.O. Box 5666, Eugene OR 97405 (mail), 3411 Willamette Street, Eugene OR 97405 (in person)

541-484-0473 (phone), 541-342-2955 (fax)

Eugene-Springfield Youth Orchestras and Eugene School District 4J

INSTRUMENT RENTAL AGREEMENT

Please return the completed form to the ESYO office directly with full payment or financial aid application form.

Instruments will not be distributed until registration is completed and payment and/or payment arrangements have been made with the ESYO office.

Check payable: Eugene-Springfield Youth Orchestras (ESYO) Mailing address: P.O. Box 5666, Eugene OR 97405 Phone number: 541-484-0473 Student (Last, First)_____________________________ Class/Orchestra_________________________ Instrument____________________ Size___________ Shoulder Rest / Rosin______________________ Rental period & rental fee: (September 2014 through May 2015)

___ $90 for SA1, SA2, LS, JO, YS ___ $60 for BEST program students Student agreement: I intend to check out an instrument from Eugene-Springfield Youth Orchestras/4J School District

and agree to be responsible for giving it the best care. Student signature ________________________________ Date________________________ Parent agreement: I agree to be responsible for up to the value of the instrument for damage or loss resulting from

accidents, neglect or failure to return the rental instrument. I understand that I will be charged $10 a month if the instrument is not returned by the end of the

rental period above and this may impact my ability to rent instruments from Eugene-Springfield Youth Orchestras in the future. I agree to return the instrument to Eugene-Springfield Youth Orchestras if payment is overdue.

Parent or Legal Guardian signature___________________________________Date______________ For office use only: QB_______ copy to Instrument Coord____check #_______ amount__________cash_________CC______

Registration package – page 10

ESYO: P.O. Box 5666, Eugene OR 97405 (mail), 3411 Willamette Street, Eugene OR 97405 (in person), 541-484-0473 (phone), 541-342-2955 (fax)

ABSENCE REQUEST FORM

In case of personal illness or family emergency, the parent is required to call the ESYO Attendance Phone at 541-505-2744

If you are planning to miss a rehearsal for reasons other than illness or family emergency, a

request must be submitted in writing to your conductor no later than 10 days before the

missed rehearsal. Musicians can miss only one rehearsal per concert set for a reason other than

illness or family emergency. It is not acceptable for a musician to miss either one or both of the

two rehearsals before a performance.

Student Name (Last, First): ___________________________________________________

Submitting Date: ___________________________________________________________

Date of Rehearsal You Will Miss: ______________________________________________

Orchestra: ___ YS ___ JO ___ LS ___ SA2

Reason for Absence:

For Conductor Use Only:

___ Excused ___ Unexcused

Conductor Signature: _______________________________________

Comments:

MUSICAL CHAIR SPONSORSHIPS ($75 per sponsorship, per year): Individual sponsorship of the EYSO musician of your choice. Any individual, family, or business may be a sponsor of a chair. Sponsors receive a listing in concert programs under their musi-cian’s name and in the donors section, one ticket to any Eugene-Springfield Youth Orchestra concert, an invitation to ESYO’s an-nual donor reception, and a photo with your sponsored chair!

GENERAL DONATIONS: There are several levels of giving. Donors receive recognition in each concert program’s donors section. Donations at the $25 level and higher receive invitation to ESYO’s annual donor reception. Donors may choose to give a restricted donation instead, designating the donation to a specific area of ESYO (i.e.: Scholarships, String Academy, Coaching, etc. Please call our development office if you have questions about designated gifts!)

IN- KIND DONATIONS: We accept in-kind donations for our annual silent auction . Please call the office at (541)-484-0473 for more information.

ADVERTISING: Advertise your business in an ESYO concert program! Information on size and price available upon request.

CONCERT/SPECIAL EVENT SPONSOR: Do you have, or know of a business that would like to partner with ESYO and help build on our mission? Opportunities for sponsorship of our 80th Anniversary Season and Special Event are now available! Sponsorship levels and included benefits are available upon request.

ESCRIP/AMAZON.SMILE/REWARDS PROGRAMS: Did you know you can support ESYO just by shopping for groceries or on-line at Amazon.com? ESYO benefits from Escrip, Amazon.Smile and Fred Meyer Community Rewards programs! Please sign up to have your purchases benefit ESYO!

THANK YOU FOR SUPPORTING EUGENE - SPRINGFIELD YOUTH ORCHESTRAS 81 st SEASON!Please detach bottom portion and return to ESYO at PO Box 5666, Eugene, OR 97405. Make checks payable to Eugene-Springfield Youth Orchestras. Donations can also be made online with a credit card online at www.ESYOrchestras.org.

Eugene - Springfield Youth Orchestras depends on the generosity of the community to help support our stellar programs! Program fees only pay a portion of what we offer to youth in the Eugene-Springfield area, as the premiere music education program and experience! There are several ways to support ESYO. See below for suggested areas of giving. ESYO is a 501(C)3 Organization. All gifts are tax deductible to the full extent allowable by law.

Support Eugene- Springfield Youth Orchestras!EUGENE–SPRINGFIELD

YES! I want to play my part in local youth arts education and support ESYO musicians!Musician ($1-99)

Musical Chair Sponsorship ($75)

Name:_____________________________________________

Address:____________________________________________

City, St., Zip:_________________________________________

Card no:___________________________________Amt:$_____

Exp date:_______________ Phone:________________________

Email:______________________________________________

Check enclosed

Credit Card

I’d like to make an In-Kind donation

Please make my gift anonymous

I would like more information about providing for ESYO in my will.

Please mail to: ESYO | PO Box 5666 | Eugene, OR 97405. Bd_13

Section Leader($100-499)

Concertmaster($500-999)

Soloist($1,000-1,499)

Conductor($1,500+)

For Musical Chairs Sponsorships Only:Not sure who to sponsor? We can choose for you!

Student name:___________________________Orchestra (circle one): YS JO LS SA2

Student name:___________________________ Orchestra (circle one): YS JO LS SA2

Student name:___________________________Orchestra (circle one): YS JO LS SA2

EUGENE–SPRINGFIELD