Youth Video Submission Form - West Coast Ragtime Society

The notes below will help the emcees to introduce you. Admission is free and there are no prizes or judging. This is a chance for you to be seen and heard around the world. The video dropbox link will be sent after we receive a completed admission form.

First name *

Last name *

Your Age *

Phone *

Email *

City & State Where You Live *

Grade School Where You Attend *

Teacher's Name & Email (if applicable)

Title and composer of ragtime piece you are submitting:

Title *

Composer *

Tell us three interesting things about you.

1. *

2. *

3. *

Those under 18 will need a guardian's consent to participate.

Comments/Questions

Last Name

If There are any questions, you may contact:
Chris Bradshaw

408-718-4270