Membership Application

Membership Application (Mid Entry)

"*" indicates required fields

Applicant Name*

Given Name (Known As) Family Name

Date of Birth*

Please upload a photo (headshot):*

Max. file size: 10 MB.

School/ ID/ Passport photos are also accepted.

School attending:*

Home Address*

Street Address Address Line 2 Suburb State Post Code

Applicant's Phone Number (if none, enter Parent's Phone Number):*

Applicant's Email (if none, enter Parent's Email):*

Enter Email Confirm Email

Name of Parent/ Carer:*

Given Name Surname (Family Name)

Parent's Phone*

Parent's Email*

Enter Email Confirm Email

Instrument & Groups

YOUTH SYMPHONY - AMEB gr 6+ / JUNIOR SYMPHONY - AMEB gr 4+ > Instruments: Flute, Piccolo, Oboe, Clarinet, Bassoon, French Horn, Trumpet, Trombone, Bass Trombone, Tuba, Piano, Percussion, Violin, Viola, Cello, Double Bass. STRING ORCHESTRA - AMEB gr 2 – 4 > Instruments: Violin, Viola, Cello, Double Bass. BIG BAND - AMEB gr 5+ / LITTLE BIG BAND - AMEB gr 3+ > Instruments: Alto Saxophone, Tenor Saxophone, Baritone Saxophone, Trumpet, Trombone, Piano, Bass, Guitar, Drums and Percussion.

Select Instrument (for Additional Instruments, please fill in a Separate Form)*

How many years have you been learning your instrument?*

Approximate Standard:*

Select Group (Orchestra)*

Select Group (Band)*

Instrumental Teacher's Name*

First Last

Instrumental Teacher's Phone:*

Instrumental Teacher's Email:*

Consent

GCYO uses newsletters, articles in newspapers, brochures, websites and other electronic media to publicize to our members and the wider community. We also collate the information in this application for the sole purpose of managing our groups. Please confirm your permission for GCYO to use your photo /or video as specified. In addition, GCYO commits to encouraging a safe, supportive, welcoming, respectful and productive environment for all. To this end, GCYO asks all members to uphold the GCYO Code of Conduct, values, policy and procedures detailed at www.gcyo.com.au Please review the Policies indicated and confirm your willingness to accept these as a condition of your Membership.

Media Consent*

By submitting this application, I agree that images of myself/ my child/ ward may be used as described above, and I can opt out at any time by contacting: enquiry@gcyo.com.au

Code of Conduct*

By submitting this application, I agree to uphold the GCYO Code of Conduct.