ALL-STATE BAND CLINIC

Registration / Cancellation Form

This form must be FAX’ed to Joe Meshach at  803-943-5036 by Friday, February 13, 2009.

    (Please Check one)                                                                                         Director’s Signature ______________________________

     Will         Won’t                                                            

    Attend      Attend     NAME                                                   LEVEL      INSTRUMENT                    SCHOOL

    ====      ====      =========================    =====     =================      =========================

1  _____     _____     ____________________________    ______     ____________________     _____________________________

2  _____     _____     ____________________________    ______     ____________________     _____________________________

3  _____     _____     ____________________________    ______     ____________________     _____________________________

4  _____     _____     ____________________________    ______     ____________________     _____________________________

5  _____     _____     ____________________________    ______     ____________________     _____________________________

6  _____     _____     ____________________________    ______     ____________________     _____________________________

7  _____     _____     ____________________________    ______     ____________________     _____________________________

8  _____     _____     ____________________________    ______     ____________________     _____________________________

9  _____     _____     ____________________________    ______     ____________________     _____________________________

10 _____     _____     ____________________________    ______     ____________________     _____________________________

11 _____     _____     ____________________________    ______     ____________________     _____________________________

12 _____     _____     ____________________________    ______     ____________________     _____________________________

13 _____     _____     ____________________________    ______     ____________________     _____________________________

14 _____     _____     ____________________________    ______     ____________________     _____________________________

15 _____     _____     ____________________________    ______     ____________________     _____________________________

(You may copy this form as needed.)