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.*

YesNo
Are you currently a member of NYO?

YesNo
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