Extra Coaching Request Form

COACHING REQUEST FORM Reason for request for individual coaching. Please be specific; if it is for an audition, tell us when and where the audition will be and with whom. If you have a printed description of requirements, attach a copy to this form. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Have you already selected your audition piece (i.e., monologue or song) or do you need help selecting something? If you have something selected, what is it? __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Do you need any other materials? For example, a recorded accompaniment, or a video tape, or recording of your work? Do you need help putting together any of these materials? __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Is there a particular Hope Academy teaching artist that you would like to work with? If yes, list the teaching artist(s). __________________________________________________________________________________________ __________________________________________________________________________________________ Private coaching is available at $15/half hour unless other arrangements have been made. Your coach will call you to schedule a time and place for the coaching and to discuss how much time you will need to prepare. You will need to pay Hope Academy before the coaching session(s). Student Name _________________________________________________________________________________________________________________ Address ______________________________________________________________________________________________________________________ School_________________________________________________________Grade __________________________ Age ___________________________ Home Telephone _______________________________________________________________________________________________________________ Parent/Guardian contact information:

Name ________________________________________________________________________________________________________________________ Work Phone ____________________________________________________ Cell Phone _____________________________________________________ If you have any questions, please call Linda Addlespurger At 412-441-3800 x43

116 S. Highland Ave., Pittsburgh, PA 15206 412/441-3800 www.cathedralofhope.org