Drumline: Request for Information

Eric J. Levy
Drumline Director
Email: levye@palmbeachstate.edu
Phone: 561-967-7222
Campus: Lake Worth
Mailing Address: 4200 Congress Avenue, MS 15, Lake Worth, FL 33461

First Name*

Middle Initial

Last Name*

Email*

Cell Phone*

Work Phone

Are you a

Palm Beach State College Student

Community Member

Alumni

Other

Other Florida College

If you chose Other or Other Florida College, please specify.

Do you have previous experience playing an instrument?*

Yes

If yes, how many years of previous experience do you have?

What instrument(s) do you play?

Where did you previously play (e.g. school, community, church)?

SCHOOL: Name of school you played at?

COMMUNITY: Name and location you played at?

CHURCH: Name and location you played at?

OTHER: If you played in any other locations, please specify.