HARMONY INSTRUCTOR SURVEY

CONTACT INFORMATION
First Name:		Last Name:	E-mail:

EDUCATION
Please select the appropriate option below:		Date of Degree Expected
Graduate Student Undergraduate Student
Instruments Played Proficiently (Check all that apply)				Please List Any Other Instruments Played Proficiently (Include Years of Study)
Guitar Trumpet Saxophone Piano Drums	Violin Clarinet Flute Bass
Years of Study For Each Instrument:				Other Music Study Experience
Guitar Trumpet Saxophone Piano Drums	Violin Clarinet Flute Bass
Please Describe Your Teaching Experience for the Instruments Checked or Described Above
Please Describe Any Additional Non-Music Teaching Experience
Please Describe Any Recording and/or Performance Experience
Please Describe Any Experience Working with Underserved Populations

references
(1) Name:	Relationship:	Telephone Number:
(2) Name:	Relationship:	Telephone Number:
(3) Name:	Relationship:	Telephone Number:

Other Information
Please Describe your expected availability (weekdays/weekend; Morning/Afternoon)
Are you willing to travel to boroughs outside manhattan?	If Yes, Please List Which Boroughs You Are Willing to Travel To:
Yes No
Would you be interested in performing for occasional student and program events?
Yes No
Please describe your interest in this program:
Please describe what you feel you can contribute to this program:
Other strengths and/or skills:
Thank you for your interest in Harmony..