2021 Registration Survey

The purpose of the survey is to gather important demographic information about our student population. This information helps us to better understand the make-up of our student body so that BKCM can program, market, fundraise for, and represent our student body more effectively. This year's survey is being driven by our Board's Diversity, Equity, & Inclusion Committee ("DEI") which is working to better understand, enhance, and support the diversity of our student body. Alongside the demographic information questions, we are asking a series of sentiment questions. Your responses to the demographic and sentiment questions will form a new baseline of data for our DEI work for years to come. We expect to ask these questions every year, evaluate the results, measure progress towards our goals, and report back to you. A more complete picture of BKCM's student body will allow us to draw better insights and guide the work of our organization's efforts to strengthen every facet of diversity, equity, and inclusion at BKCM.

Your survey information is confidential. We will only be reporting on this data in aggregate and not on individual students/families. The aggregated data will be shared within the Board (including the DEI Committee), Staff, and specific institutional funders like large foundations and the City government who require this information as part of their support for BKCM.

Thank you for completing this survey.

___________________________________________________________________________________

Primary Adult Record ID

Additional Adult Record ID

Primary Adult First Name

As the first part of the registration process for the 2021-2022 school year, please complete this form.

Who in your household is enrolling in lessons or classes at BKCM? Check all that apply.

MyselfMy spouse/partnerMy child(ren)/dependent(s)

Suzuki parents not enrolling in additional programs at the Conservatory should select My child(ren)/dependent(s).

Your Contact Information

First, tell us a little about you. Please provide the best email, phone number(s), and address for BKCM to reach you.

First Name

Last Name

Date of Birth

MM/DD/YYYY

Preferred Email Type

Email

Preferred Phone Type

Mobile Phone

Home Phone

Street

Please include apartment number, if applicable.

City

State

Postal Code

Which option best describes the field or industry in which you work?

What is your occupation? (Optional)

Who is your employer? (Optional)

Please write out the name of your company Ex: Department of Education

Company's Website (Optional)

Your BKCM Enrollment

Please use the questions below to provide additional details about your registration.

What primary program do you plan to enroll?

Community Music SchoolMusic TherapySuzuki

Which Community Music School Program(s) are you enrolling in?

What is your primary instrument? Alternatively, you may select Composition or Theory

You indicated Other for Primary instrument. Which instrument do you play?

Have you enrolled in the past?

What was the last year of enrollment?

You mentioned that your child(ren)/dependent(s) will enroll at BKCM. Is there another adult in your household who should be listed as an additional parent/guardian?

YesNo

Additional Adult's Contact Information

You mentioned that your spouse/partner would be enrolling at BKCM. Tell us a little about your spouse/partner, including the best email, phone number(s), and address for us to reach them.

Please tell us about the additional parent/guardian, including the best email, phone number(s), and address for BKCM to reach them.

First Name

Last Name

Date of Birth

MM/DD/YYYY

Gender

Please describe their gender.

Preferred Email Type

Email

Preferred Phone Type

Mobile Phone

Home Phone

Does this person share your address?

YesNo

Street

Please include apartment number, if applicable.

City

State

Postal Code

Which option best describes the field or industry in which they work?

What is their occupation? (Optional)

Who is their employer? (Optional)

Please write out the name of your company Ex: Department of Education

Company's Website (Optional)

Additional Adult's BKCM Enrollment

Tell us a little about your spouse/partner's planned enrollment.

In which program does your spouse/partner's plan to enroll?

Community Music SchoolMusic Therapy

Which Community Music School Program(s) are your spouse/partner's enrolling in?

What is your spouse/partner's primary instrument? Alternatively, you may select Composition or Theory.

You indicated Other for Primary instrument. Which instrument does your spouse/partner play?

Has your spouse/partner enrolled in the past?

What was the last year of enrollment?

Our Board Diversity, Equity & Inclusion Committee is working to better understand, enhance, and support the diversity of our student body. Alongside the demographic information questions asked earlier in this survey, in this section we ask a series of sentiment questions. Your responses will form a new baseline of data for our Diversity, Equity, & Inclusion work for years to come.

For each of the following sentiment questions, please indicate how you feel about each statement on a scale from Strongly Agree to Strongly Disagree. Please do your best to represent the feelings of your household.

	Strongly Agree	Agree	Neither Agree Nor Disagree	Disagree	Strongly Disagree	Prefer not to answer/ No opinion
BKCM is a welcoming and safe space.
BKCM is a place where people of all backgrounds, races, ethnicities, religions, sexual orientations, gender identities, and abilities can come together and learn from one another.
I (and my child) belong at BKCM.
I believe BKCM is committed to diversity, equity, and inclusion.
My or my child’s teacher(s) creates an inclusive environment.
I or my child have learned about or been exposed to a diverse repertoire of music created by composers from different musical traditions, backgrounds, races, and gender identities.
BKCM makes a meaningful impact on my life.