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Mentor On Call Registration Form

Group Leader Information

First Name *

Last Name *

Email Address *

School/Group Information

Name of Group *

City/Town *

Country *

Region *

Age Range of Group *

4 - 7 years old 8 - 11 years old 12 - 13 years old 14 - 16 years old 17 - 18 years old 18+ years old

Please tick all that apply

How many young people are in your group? *

Type of Group/School *

Please include the type of instruments and your genre

Does your group have any access requirements?

Please enter N/A if not applicable

Your Mentor On Call Session

To help us to match you with a Music Mentor, please tell us what the focus of the session would be for you: *

Musical help or advice Wider conversation Rebuilding post lockdown Career paths for students Other – please specify

Other - Please Specify *

Availability – Please select which days/times are best for your group: *

Monday AM Monday PM Tuesday AM Tuesday PM Wednesday AM Wednesday PM Thursday AM Thursday PM Friday AM Friday PM Saturday AM Saturday PM Sunday AM Sunday PM

Please select all that apply

Data Collection

How did you find out about this programme *

Social Media Email from MFY Word of Mouth Local Music Service Other - Please Specify

Please specify *

For more information about our privacy policy, please visit the 'Policies' section on our website. By clicking here you agree that we may process your information in accordance with these terms *

I would like to join the MFY mailing list to be kept updated on upcoming MFY news and events *

Yes No

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Regional Festival 2022
Mentor On Call Registration Form

Music for Youth

Music for Youth
CBSO Centre
Berkley Street
Birmingham
B1 2LF

Tel: 020 8106 5825

Email: mfy@mfy.org.uk

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Music for Youth is a registered charity, no. 285831

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