Newcastle Wind Orchestra 2019

Newcastle Wind Orchestra 2021
Rehearsals for NWO are on Wednesday evenings from 7pm - 9pm at The Junction Public School. Commencing 3rd March 2021
Member Name

First NameLast Name
Birth Date

DayMonthYear
Gender
School or University year in 2021 (if applicable)
Instrument
Instrumental Teacher - if applicable
AMEB Level or Equivalent (please note syllabus if not AMEB)
Newcastle Wind Orchestra Fees

$175 per semester - 2 semesters per year
Address

Street Address

Street Address Line 2

CityState

Post CodeCountry
Phone Number
Mobile Number
Email Address
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 CodePhone Number
Mobile Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
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.
Are you currently a member of NYO?
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
Should be Empty:

Newcastle Wind Orchestra 2021

Rehearsals for NWO are on Wednesday evenings from 7pm - 9pm at The Junction Public School. Commencing 3rd March 2021

Emergency Contact Details