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ROOTS OF RHYTHM WORKSHOP REGISTRATION


Sign up for hands-on lessons for immediate use by music therapists and music educators featuring Roots of Rhythm author, educator, and ethnomusicologist Dr. Craig Woodson
* Required

Which workshop will you be attending: *


First Name  *   Last Name  *      
       
Address  *          
         
City  *   State  *   Zip  *  
     
Home Phone  *   Work/Cell Phone  *      
       
Email  *          
         
 
 
School Information
 
School name   Address      
       
City   State   Zip  
     
Phone Number   Fax Number      
       
Email   Principal's Name      
       
 
 
Teaching Information
 
1. Number of Years Teaching:
Less than 5   5 - 10   10 - 20   More than 20  
 
2. Grade:
Fourth   Fifth   Sixth   Seventh   Other    
 
3. Class Size:
15 - 20   20 - 25   25 - 30   More than 30  
 
4. Are you a music teacher?
Yes   No  
 
5. What musical experience do you have?
None   Beginner   Intermediate   Advanced  
  
6. How did you find out about the Roots of Rhythm program?
Roots of Rhythm Brochure
PMC website
Another teacher / administrator
Arts-in-Education organization
Music retailer
Other:
 
7. Why are you interested in the Roots of Rhythm program? (Check all that apply):
Widen students' world knowledge
Personal interest in music
Prepare students for assessment
Professional development
Cross-curriculum instruction
Other:
 
8. For what discipline will you primarily use Roots of Rhythm?
Social Studies
Math
Science
Technology
Arts & Music
Other:
 

Percussion Marketing Council
Market Research & Program Consent Form

The Percussion Marketing Council (PMC), a non-profit trade organization and creator of the Roots of Rhythm curriculum, is seeking to identify and provide additional resources, activities and other support for Roots of Rhythm programs by soliciting feedback from teachers who have attended Roots of Rhythm teacher training workshops offered by PMC, International House of Blues Foundation, Ethnomusic, Inc. and others, and are interested in receiving additional information related to the program/curriculum.

By checking the following boxes and providing your contact information, you are choosing to be included in the PMC's official Roots of Rhythm mailing list and giving us permission to:

Contact you to request your voluntary participation in connection with PMC Roots of Rhythm program surveys and market research.
Provide your name and contact information to PMC's Roots of Rhythm sponsors, including percussion manufacturers and music dealers, for the purposes of providing you with information about Roots of Rhythm related instruments, promotions, discounts and special offers.
Include your name and contact information in a searchable, online database of Roots of Rhythm instructors, teachers, and authorized World Drumming Centers.