Partner School Application

Partner School Application

We want to learn more about your school and whether Education Through Music-LA may be able to assist your plans to develop a school-wide music education program. Please complete the information below. Please direct all questions to: info@etmla.org Phone: 818-433-7600 / Fax: 818-433-7601

Basic Information

Name of School*

School District (or archdiocese/charter network if applicable)*

Local District (if applicable)*

Website*

Email*

Main Contact*

First Name

Last Name

Title*

Contact Email*

School Phone*

School Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Total School Enrollment*

How many classes per grade level does your school have?*

If your school includes combination classes (i.e. 5th/6th split, TK, etc) please include those as well.

Please describe any music instruction currently being provided and how long it is offered (year-round, one semester only, elective-wheel) *

If your school includes combination classes (i.e. 5th/6th split, TK, etc) please include those as well.

Demographics*

(% Hispanic/Latino, % American indian, % Asian, % Pacific Islander, % Filipino, Not Hispanic/Latino, % African American, % White, Not Hispanic, % Two or More Races, Not Hispanic, % Not Reported)

What are your school's neighboring feeder schools?*

Please attach your current Bell Schedule.

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Title 1 Percentage / Student Equity Need Index / Socioeconomically Disadvantaged*

Detailed Information

Please share your school's mission statement/core values:*

What has been the history of arts education at your school?*

Please comment on the state of the following at your school: *

Please describe your relationship with the school district's arts education programs, if applicable.*

Is bringing a school-wide music program an initiative in which your principal is invested, and which your principal would lead?*

What is your overall and long-term vision for a school-wide music program?*

Who are the current stakeholders in planning for a school-wide music education program?*

How does the school plan to ultimately sustain the program long-term?*

7) On a scale of 1-5 (1=least, 5=most), how prepared is your school community to embark on developing a sustainable music program?*

1 2 3 4 5

Principal Signature/Approval*

[clear]

Use your mouse or finger to draw your signature above

Office Use / Notes / Status