Name ______________________________Today’s date________ 

 Please note: Total 15 extra credit points per 9 week period

and this form needs to be turned in within 1 week of the concert or show.

 Pick only one:

 ____ Live performance (5 extra credit points)

            (Symphony, band, choir, rock, country, etc)

_____ Student performance (3 extra credit points)

(Church, family reunion, school talent show, etc)

            Do not include solo/ensemble contest.

____ Televised performance (watch at least 30 minutes)

            (2 extra credit points)

____ Television show detailing the history of instruments,

            composers or musicians. (2 points)

____ Radio concert performance (30 minutes)

            (2 extra credit)

Details:

Who: ____________________________________________________________

What: ___________________________________________________________

When: ___________________________________________________________

Where: __________________________________________________________

Write one or two sentences about your extra credit:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Parent signature: _______________________________________________