Oregon State University Bands
New York City Travel Info Form

Required of all travelling members.

posted: January 16, 2008

2008 NYC Info Form
Legal Last Name:
Legal Middle Name:
Legal First Name:
Nickname:
Section:
Email:
Sex:
Birthdate: Format: MMDDYYYY, ex: 03021976 for March 2, 1976
Your Contact Info:
Phone: [format: 5415551234]
Cell Phone: [format: 5415551234]
Current Mailing Address
Mailing Address:
City/State/Zip:
Your instrument in case
If no instrument, please leave '.'s in these spaces
Weight: in pounds.
Height: in inches.
Width: in inches.
Depth: in inches.
Emergency Contact Information
Emergency Contact Name:
Relation to you:
Emergency Contact Phone (Day): [format: 5415551234]
Emergency Contact Phone (Eve): [format: 5415551234]
Medical Information
Medical Conditions:
Allergies:
Medicines currently taking:
Asmtha inhaler: Do you carry an inhaler?
Questions
I have DOUBLE-CHECKED all data for correctness and completeness.

Comments or questions?