Banding Together to Protect Hearing

Email

First name

Last name

Role

Other

Best Email (if different from above)

Name of School (if no school affiliation, type N/A)

Number of Students You Teach

Name of Band Director or Music Teacher

Email for Band Director/Music Teacher

Zip code (for approximate school location)

Best Phone number (optional)

Where did you hear about Ear Peace Foundation?

I am interested in receiving the Ear Peace Foundation's free classroom program on Noise-Induced Hearing Loss and Its Prevention. (Teachers who educate their performing music students become eligible to receive significant discounts on filtered musicians' earplugs for themselves and their students.)

Please send me a link with the downloadable program.

Comments: Please feel free to provide us with any additional information about your specific interests.

Send questions or requests to us at info@earpeacefoundation.org with Subject Line: Protect-A-Band Information

PROTECT-A-BAND FORM

info@earpeacefoundation.org

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