YOUTH ENSEMBLE PROGRAM APPLICATION

Student Personal Information
Pronouns (Check all that apply)

We're unable to accept onto the program any child who is younger than 14 on June 1st, 2021.

Parent/Guardian Personal Information

CONTACT

(570) 230-7277

info@scrantonshakes.com

SSF Mail

P.O Box 20116

Scranton

PA, 18502

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