Community Impact Programming: Institutional Questionnaire

Thank you for your interest in MSM's Community Impact Programming. To utilize this service, please share details about your event/opportunity by completing the form below. The Center for Career Readiness & Community Impact (CCRCI) office will review your information and then reach out to confirm your request.

INSTITUTION INFORMATION

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Institution Name

Primary Contact Name

Additional Contact Name

Phone Number:

Email Address:

Nearest subway line:

Are you able to offer an honorarium?

About your institution

In the space provided, please tell us about your institution and/or provide a URL to your institution's website, highlighting the services you offer.

PERFORMANCE SPACE

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Where will the concert be given?

Auditorium
Cafeteria
Lobby
Other

Is there a stage?

Is there a piano?

Is there a PA system?

AUDIENCE

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How many people will attend?

Fewer than 30
30 - 49
50 - 99
100+

What type of music is preferred?

Classical
Broadway
Jazz
Opera
Dance Music

Type of Concert?

Vocal
Instrumental

Do you have any specific song requests?

What is the preferred date/time of your concert?

How long is your concert?

Hours:Minutes (including any desired intermissions)

Is your site interested in musical instruction?

Is there any additional information about the audience you would like to share with us?

Please note: Performances are presented Monday-Friday only, October-December and January-April.

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