Newcastle Wind Orchestra 2019

Address *

Phone Number *
Mobile Number
Email Address *
Is the member of Aboriginal or Torres Strait Islander origin?

Aboriginal Torres Strait Islander No Prefer not to answer
Emergency Contact Details

In the event of an emergency, I would like for Newcastle Wind Orchestra to contact the following person.
First Name *
Surname *
Relationship to applicant *
Phone Number *

Area Code Phone Number
Mobile Number

Area Code Phone Number

Address

E-mail
Medicare Number *
Known Allergies or medical conditions of the member
In the event of injury or illness, if the emergency contact is unavailable, I authorise a staff member of Newcastle Wind Orchestra to organise appropriate medical attention on my behalf. I acknowledge that all medical costs incurred are my responsibility. *

Yes No
Instrument *
AMEB Level or Equivalent (please note syllabus if not AMEB) *
Are you currently a member of NYO?

Yes No
Instrumental Teacher - if applicable *
Teacher's Email Address or Phone Number *
Newcastle Wind Orchestra Fee Schedule 2019

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Newcastle Wind Orchestra Fees

$150 per semester - 2 semesters per year
Confidentiality

All information gathered in this form is held in confidence by NYO.
Form completed/signed by (must be signed by a parent or guardian if the applicant is under 18 years of age) *
If you have any questions with regards to the application please email sally@nyo.com.au
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