Girls Make Beats Interest Form

Can't make our current program dates? No problem! Let us know you're interested and we'll keep you updated on future opportunities.

Parent/Guardian Information

Parent/guardian first name

Parent/guardian last name

Parent/guardian Email

Parent/guardian Phone

Student first name

Student last name

Student's date of birth

Month

Day

Year

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

City

State

Choose:

Virtual

In Person

Both

Time that works best

Preferred program format

Multi-day intensive

Weekly sessions over several weeks

Summer camp style

Which areas interest your student most?

Select all that apply

Additional Information

Please share any additional context that might help us.