String Scholarship Agreement Form

Choose your instructor and sign the agreement for your Scholarship with this form.

Name of String Scholarship Winner(Required)

First Last

Email of Parent of Winner(Required)

Cell Phone Number of Parent or High School Student(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Prefered form of contact

Phone Call

Text

Mail

If you are playing the violin - VIOLIN Teacher Choice: The La Crosse Symphony Orchestra will provide up to $150 per semester for two semesters for your child to study with an LSO musician. You are required to pay the instructor any additional lesson charges. Please indicate who you choose for your instructor:

If you are playing the cello - CELLO Teacher Choice: The La Crosse Symphony Orchestra will provide up to $150 per semester for two semesters for your child to study with an LSO musician. You are required to pay the instructor any additional lesson charges. Please indicate who you choose for your instructor:

If you play the viola - VIOLA Teacher Choice: The La Crosse Symphony Orchestra will provide up to $150 per semester for two semesters for your child to study with an LSO musician. You are required to pay the instructor any additional lesson charges. Please indicate who you choose for your instructor:

Consent

I permit my child's name and picture to be included in official LSO postings.

Your child might be featured in a press release in the La Crosse Tribune, on the LSO Facebook page, and will be in the LSO season program book. By signing this form, you have permitted the LSO to include your child in these publications.

We would like our 2 Season Tickets

We accept the 2 season tickets in the upper balcony for the 2022-23 season. Please mail them to us!

We understand we do not bill the LSO for anything.

Your instructor will bill the LSO office for his/her reimbursement. The instructor will bill you for the difference. (Or whatever agreement you have worked out with the instructor.) You do not have to bill the LSO for anything.

We understand that auditions are required to accept this part of the scholarship.

Your child receives 50% off tuition with the La Crosse Youth Symphony Orchestra. Please email [email protected] or call at (608) 796-9508 for details on auditions.

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String Scholarship Agreement Form

String Scholarship Agreement Form

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