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Girls Make Beats Interest Form

Student Information

Student's date of birth
Month
Day
Year

Parent/Guardian Information

Has the student participated in Girls Make Beats programs before?
Yes
No
Student's music experience level
Complete beginner
Some experience with music
Intermediate level
Advanced level

Location

Program Preferences

Choose:
Virtual
In Person
Both
Preferred months

Select all months that work for you

Preferred program format
Which areas interest your student most?

Select all that apply

Please share any additional context that might help us.

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