Please complete this form to request placement with a Mentor. If you would like to be a Mentor, please click here.

Please note that an asterisk (*) denotes a required field. If you do not have an answer for a required field, please type or select "N/A" or the number zero (0) in the blank.

Your First Name*
 

Your Last Name*

Organization

Organization's Street Address

City

State

  please select your state Oklahoma Texas    

Zip Code
  +

Organization's Telephone Number

Organization's E-mail Address

Your Home Street Address*

City*

State*

  please select your state Oklahoma Texas    

Zip Code*
  +

Home Telephone Number*

E-mail Address*

To contact me, please use my*   organization information  home information

I direct    choirs*(specify number of handbell/handchime choirs)
 

We have    octaves of handchimes.*

We have     octaves of handbells.*

My choir(s) consist of* (please check all that apply)

children (up to age 12 )

youth (ages 13-18)

adults (ages 18-50)
older adults (ages 50+)

My choir(s) ability level is* (please check all that apply)

beginner (level 1 and 2 music)

intermediate (level 3 and some 4 music)  

advanced (level 5 and above).

My music background is*

 very limited

played an instrument/sang in choir

limited amount of formal music training

some college music courses

college degree in music

My experience with handbells/handchimes is*

 nonexistent.

I have rung before, but never directed.

I have rung for years, but am new to directing.

I would like a mentor to help me with...*

(2,000 word limit)
 

If there are no mentors in my city, check the following nearby locations:

Please answer one of the following for COPPA Compliance*

  I certify that I am over 14 year of age.

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