School Name*

School Address*

City*

State* ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Zip Code*

Phone* - -

How will this Assembly be paid for?* BOCES
Purchase Order
Parent Group
School Funds
Arts Council/Organization
Other

Contact Name (Your Name)*

Phone Number* - -

Email Address*

How would you prefer to be reached?Phone Email No Preference

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Grades Level(s) Attending
Check All That ApplyK-2
3-5
6-8
9-12

Number of Shows* 123

Approximate Number of Students Attending Performance*
To protect the quality of the performance for the students please limit the number of students attending to 250 per show.

Time of Show(s)*

If the performance area is NOT a stage, please choose the option below that best describes the space: Gym
Multi Purpose Room
Classroom
Other

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Questions/Comments:

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