Please fill in all sections of this application. School Information School Name: School Address: City, State and Zip: Principal's Name: School Phone: Contact Person: Position: Email: Contact Phone: Tickets Grade Levels Attending: 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Number of Students per Grade: Please select the day and time you would like the performance to take place in order of preference. Performance dates must be booked 4 weeks in advance. First choice: ---October, 2015November, 2015December, 2015January, 2016February, 2016March, 2016April, 2016May, 2016June, 2016 Second choice: ---October, 2015November, 2015December, 2015January, 2016February, 2016March, 2016April, 2016May, 2016June, 2016 Third choice: ---October, 2015November, 2015December, 2015January, 2016February, 2016March, 2016April, 2016May, 2016June, 2016 Which ensemble would you like to request? To select multiple ensembles hold the shift key while clicking the desired options. View ensemble descriptions (opens in a new window) The Two-Frog DuoWoodwind QuartetA Piacere String QuartetThe Classical Jazz EnsembleThe Hartford Symphony String QuartetThe Mosaic String TrioThe Wind Quintet Ensemble costs run between $450 and $1,850. However, subsidies may be available. Please contact Miriam Engel at email@example.com to discus?s. Do you have a specific theme you would like us to tie into your curriculum, if possible? If yes, please describe: Has your school ever had a Hartford Symphony Ensemble perform? yes no In School Ensembles Policies and Requirements (opens in a new window) I confirm that all information submitted is correct and agree to the terms stated in the Policies and Requirements. I understand my responsibility and financial obligations to the Hartford Symphony Orchestra. I booked my participation through Hartford Performs and my voucher number is: I accept these terms: Upon receiving the completed form, an education staff member will contact you with available dates starting with your preferred month. Applications will be handled on a first come first serve basis. Thank you for choosing the Hartford Symphony Orchestra Education Programs. We look forward to working with you and your students this year.