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MICCA Marching Band Registration - Northeast District II

Wakefield High School
Saturday, October 20th, 2018

Checks payable to: Wakefield Music Boosters
Please mail your Check or Purchase Order to:
Tom Bankert, Wakefield High School
60 Farm Street, Wakefield, MA 01880

Participation Fee: $150.00 Check Mailed P.O.
(Checks payable to: Wakefield Music Boosters)
Name of School:
Name of Band:
School Address:
Zip Code:
School Phone:
Phone Extension:
Director's Name:
Director's Home Phone:
Director's E-mail:
Director's Home Address:
Director's City:
Director's State:
Director's Zip Code:
Division Entering:

Please check this box to certify that this form is
complete and that you are ready to submit.