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Class Act New Schools Application
Application Deadline: March 24, 2015 at 5:00pm
Applications will not be accepted after the deadline
Please complete this application for participation in Pacific Symphony’s elementary school partnership program,
Class Act for the upcoming 2015-2016 school year. Applications are due no later than March 24th, 2015 at
5:00pm. Applications should be sent to:
Carrie Villanueva, Manager of Education
Pacific Symphony
3631 S. Harbor Blvd., Suite 100
Santa Ana, CA 92704-8908
cvillanueva@pacificsymphony.org
Fax: (714) 755-5789
E mail is the preferred method of application submission, though applications will also be accepted by fax, U.S.
Mail, or hand delivery between 9:00am and 5:00pm, Monday-Friday.
Please note that this application should be completed by your school’s principal for the 2015-16 school year. If
you will have a new principal for the 2015-16 school year, your new and departing principal may complete the
application together. If your new principal has not yet been identified, please contact Carrie Villanueva
immediately to discuss possible options.
Name of School
District
Principal
Vice Principal
Preferred Contact Person
Title
E-Mail
Thank you for your interest in Class Act! Please make sure to read through the Class Act Application Information
Packet before completing your application to familiarize yourself with current program details and any changes
that might be made for 2015-2016.
Please feel free to contact Carrie Villanueva at cvillanueva@pacificsymphony.org or (714)876-2347 if you have any
questions concerning your application. We will update you on your application status by June 5, 2015.
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Application Check list
Please verify that you have completed the following before submitting your application. Please
note that only complete applications will be considered.
___ Read and Reviewed Class Act Application Information Packet
All team members should read and review this section before the principal completes the school’s
application. Please do not include the Information Packet with your completed application
___ Completed Part I, Application Instructions, Site Visit Availability, Principal’s Statement. This
section requires the principal’s signature
___ Completed Part II, General Information. This section should be completed by the principal
___ Completed Part III, Level Choice. This section should be completed by the principal
___ Completed Part IV, Proposed Team Member List. This section should be completed by the
principal
___ Completed Part V, Application Narrative. This section should be completed by the principal
___ Additional letters of support from other candidate team members, including Teacher
Representative(s), Music Teachers and Parent Coordinator(s) (Optional), attached to completed
application. These letters are optional.
Applications will be accepted via e mail, fax, U.S. Mail or by hand delivery. E mail is the preferred
method of delivery.
Applications will not be accepted after March 24th, 2015 at 5:00pm
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Part I
Application Instructions, Site Visit Availability, and Principal’s Statement
Please read all instructions before completing your application. Please remember to read and sign the Principal’s
Statement.
Application Instructions
1) Applications must be completed by your school’s principal for the 2015-16 school year. Unfortunately we
cannot accept applications completed by other members of a school’s community. If your school’s
principal will change for the 2015-16 school year, please make sure that the incoming principal completes
this application. Your current principal may assist the new principal if needed. If your new principal has
not yet been identified, please contact Carrie Villanueva immediately to discuss possible options. Please
note that Class Act is an elementary school partnership program, serving students primarily in grades K-6,
though K-8 schools may also apply.
2) Other candidate team members, such as Parent Coordinators, Teacher Representatives, or Music Teachers
are also welcome and encouraged to include additional letters of support at the end of the application.
We welcome the opportunity to hear from these valued team members.
3) Before completing your application, all team members should read through the Class Act Application
Information Packet. This is a separate document. Even though some team members or schools may have
participated in Class Act before, please note that there have been significant changes to Class Act over the
past few years.
4) You will be asked to provide site-visit availability. Availability is given in time blocks and site visits will take
place during mid to late-April. We will notify you if your school has been selected for a site visit by
March 27, 2015.
5) Please remember that if you choose to apply, you will be taking part in a competitive application process,
where both current and new schools will be considered for the Class Act program. As such, please take the
time to read through all materials carefully, verify that you have completed all sections of the application,
and that your submitted materials reflect your school’s commitment to becoming a part of the program.
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Site Visit Availability
Please select five possible site visit dates and times below, ranking your choices from 1-5. Site visits generally
last 1.5-2 hours, and will be scheduled within the timeframes listed. Please note that not all schools will be
granted site visits.
April 13 (Monday)
____ 9:00am-11:00am
____ 2:00pm – 4:00pm
April 20 (Monday)
____ 9:00am-10:30am
____ 12:00pm-1:30pm
____ 2:30pm – 4:00pm
April 14 (Tuesday)
____ 9:00am-12:00pm
April 22 (Wednesday)
____ 1:00pm – 4:00pm
April 16 (Thursday)
____ 1:00pm – 3:00pm
April 24 (Friday)
____ 10:00am-12:00pm
____ 1:00pm – 4:00pm
April 17 (Friday)
____ 10:00am-12:00pm
Principal’s Statement
I acknowledge that I have read the Class Act Application Information Packet
Specifically, I have read and understand
 Financial Commitments
 Program Elements
 Partnership Commitments
As outlined in the Class Act Application Information Packet
If my school is selected for the Class Act Partnership, and I accept the offer, I:
 understand that my school will be responsible for the Class Act Financial Commitment, as it pertains to my
assigned level of participation
 agree to perform and/or support all Class Act duties outlined in the Application Information Packet during
the 2015-16 school-year
 feel confident that the team members listed on my application are willing and able to fulfill their respective
roles in the partnership
 understand that my acceptance is tentative until all program element details for 2015-2016 have been
finalized, I have reviewed the final Partnership terms, and have been issued and signed a formal Partnership
Agreement with Pacific Symphony
 understand that a financial deposit may be required upon formal acceptance
I will be my school’s principal for the 2015-16 school year and I have personally completed this application.
Principal’s Signature:
Date:
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Part II
General Information
Your school may have provided some of this information previously. We do ask that you complete this section to
ensure that all of our information is current and correct. Thank you for your help with this!
School Name
District
Address
City
School Phone
Zip Code
Fax
Grade Levels
Number of Students
Number of Teachers
Please complete the table below, providing information on the number of classes, students, and teachers in
each grade at your school.
Grade
Number of
Classes
Number of
Students
Number of
Teachers
TK*
K
1
2
3
4
5
6
7
8
Total
*Please include TK (Transitional Kindergarten) info ONLY if TK classes are separate from K classes
Does Your School have Title 1 Status?
____Yes
____No
___________________________
15-16 School Year Start Date
Is your school?:
____ Traditional
____________________________
Available Start Date for Class Act
Scheduling, if selected
___Year Round
____Multi-track*
*Please detail number of tracks and track schedule:
Do you have a music program?
Is your district part of Arts Advantage?
____Yes
____Yes
____No
____No
If your school has a music program, please detail the grades it serves, frequency, length, and type of instruction
(instrumental, general, vocal/choral) below:
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Transitional Kindergarten
1. Will your school have Kindergarten) during the 14-15 school year? TK (Transitional
____ YES
____NO
(If “No”, please continue to Youth Concert section below)
2. Are your TK classes combined with regular Kindergarten classes or separate?
_____ Combined
_____ Separate
3. Is it your intention to have your TK classes fully participate in all aspects of Class Act at your school in the same way
Kindergarten classes do, including Prelude Assemblies, Lessons, Bravo and IME Assemblies?
_____ YES
_____ NO
4.
Do your TK classes follow the same daily schedule as your Kindergarten classes?
_____ YES
____ NO*
*If “No”, please explain the differences between TK and K schedules:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
5. Please share with us any additional info you can on how the Transitional Kindergarten works at your school, your
policies of integrating TK classes into regular Kindergarten activities and events, and any other details that might
help us address how TK may, or may not, fit into the Class Act program at your school:
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
Youth Concerts
New, for the 2015-2016 year, we are pleased to offer schools the option of having their 1 st graders attend
EITHER the Youth Concert OR the on-site Interactive Musical Experience (IME). For planning purposes, schools
that opt to bring their 1st graders to the Youth Concerts on their application MUST commit to bringing them to
their school’s assigned Youth Concert date. Please choose one option below to let us know your preference for
your 1st graders:
____ Youth Concert Option:
Our 1st graders will attend the Youth Concert with the rest of our students in 2 nd
grade and higher. By choosing this option we are committing to bringing our 1 st graders to our assigned Youth
Concert for the 2015-2016 school year. Our Kindergarteners will continue to have the IME Assemblies on-site.
____ IME Option:
Our 1st graders should be scheduled for, and will attend, an Interactive Musical Experience
(IME) assembly with our Kindergarteners. They will not attend the Youth Concert.
2015-2016 Youth Concert Dates: June 1st, 2nd, 3rd and 6th, 2016
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Part III
Level of Participation and Level Choice
WHICH LEVEL IS RIGHT FOR MY SCHOOL?
Level II, a Great Fit for Most Schools
The majority of Class Act schools choose to participate in Level II, Traditional Class Act Program. Level II
provides a mix of small and large group lessons and assemblies, on-site performances, and Youth Concert
attendance. Schools who participate in Level II generally have the highest level of engagement and satisfaction
with Class Act.
Level III*, Deeper Involvement for Lower Grade Students
*Level III is not available for New Schools. The program includes Orff-Schulwerk based lessons for students in
grades K-2 or K-3.
Other Level Options and Customization
Level I Plus, on-site program with no Youth Concert attendance
Class Act is a program of Pacific Symphony. Most schools choose to partner with Pacific Symphony
through Class Act because they value the concert attendance component. New Schools who are
unable to attend an off-site concert, for whatever reason, may apply for Level I Plus for their first
year only. Allowing new schools to participate at Level I Plus for their first year serve as an entry
point for new schools to the program while providing additional time for new schools to financially
prepare to move to the Level II program in subsequent years.
Other customizations
Other program customizations may be possible. Please contact Carrie Villanueva should you wish
to discuss additional options.
All new schools are encouraged to consider applying for Level II, to ensure the greatest level of
satisfaction and learning for their students.
You can learn more about the levels of participation available to schools in greater detail in the Class Act
Application Information Packet. Please look through these pages carefully before making your decision about
which level you feel would be the best “fit” for your school.
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Level Choice
Please note that if selected for Class Act, your school will be assigned to one Level. Schools may not participate at
multiple levels within the same school year. You are welcome to include a 1 st and 2nd choice on this application
and will be asked to discuss your level choice(s) further in your narrative.
____ LEVEL II Traditional Class Act
The Level of Choice for the Majority of Class Act Schools





Program Elements include: Prelude Assembly, Classroom Lesson, Family Night, Youth Concert
(students 2 and higher), Interactive Musical Experience (students in grades K-1), Teacher Workshop
(all teachers), Bravo Assembly
Required Team Members: Principal, Teacher Representative (2), Parent Coordinator (2), Music
Teacher (if applicable)
Financial Commitment: $4.90 per student, plus busing expense to Renée and Henry Segerstrom
Concert Hall for students in grades 2 and higher
Supplementary Volunteer Commitment: 10 volunteers for Youth Concerts or Family Musical Mornings
All students participate, grades K and higher
 More details on Level II can be found in the Application Information Packet
*IMPORTANT: please note this change for the 2015-16 school year. 1st grade students are required to attend
EITHER the Interactive Musical Experience OR the Youth Concert. Your school should note which option you
choose on your application
LEVEL III*, Traditional Class Act with Orff-Schulwerk Lessons
More In-Depth Approach for Lower Grade Students
*Level III is not available for New Schools, however you may want to consider it for future years
Please see the next page for additional options for your school’s participation in Class Act
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____ LEVEL I PLUS
My schools is NOT able to commit to participating in the LEVEL II program. We are interested in
continuing a less-involved program that does not include concert attendance and understand
this option will only be available for 1 year.
o Program Elements include: Prelude Assembly, Individual Classroom Lessons, Family Night,
Teacher Workshop (all teachers), Bravo Assembly
o Required Team Members: Principal, Teacher Representative (2), Parent Coordinator (2), Music
Teacher (if applicable)
o Financial Commitment: $4.90 per student
o All students participate, grades K and higher
 More details on Level I plus can be found in the Application Information Packet
IF you have chosen Level I or I Plus as your preferred level of participation, please share with us why you
have done so (choose all that apply):
_____ Our school cannot afford the Level II program participation fees
_____ Our school cannot afford the bussing costs for the Level II Youth Concerts
_____ Our school prefers not to have the off-site Youth Concert element (for reasons other than
financial). Please elaborate your school’s situation:
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_____ Our school cannot commit to providing 10 volunteers as part of the Level II program
_____ Other Reason(s):
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
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Part IV
Proposed Team Member List
The success of Class Act depends upon the clearly defined commitments of all partners. Please read and review
details of each team member’s commitment to the program, outlined in the Class Act Application Information
Packet. Once you have read through the commitment, please list your proposed team members, taking care to
choose individuals who are able to fulfill the commitments outlined in their job descriptions. You will have the
opportunity to list additional team members on the next page.
Required Proposed Team Members
Please list below, including all required team members
Teacher Representatives
Two required, one from the lower grades and one from the upper grades
_____________________
Lower Grade Teacher Representative (Required)
_____________________
Upper Grade Teacher Representative (Required)
Parent Coordinators
Two required. Please note that the vast majority of Class Act events occur during the school day, and AT LEAST
ONE Parent Coordinator MUST be available to supervise school-site events that occur during the school day on
a consistent basis.
_____________________
Parent Coordinator #1 (Required)
_____________________
Parent Coordinator #2 (Required)
Music Teacher
If your school has a music teacher, he/she is a required team member
_____________________
Music Teacher (Required if school has a music teacher)
Please note: If your school has special circumstances that make it impossible to provide the required team
members requested above, please detail these circumstances below and propose how your school might fulfill its
commitments through other means.
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
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Optional Team Members
Your School is welcome and encouraged to have additional team members, such as a third, and even fourth,
Parent Coordinator or Teacher Representative. Your school may also have an Ambassador (assigned by Class Act
staff), more than one music teacher, or may wish to include your office manager or librarian as part of the Class
Act Team.
Please list any additional (optional) team members and their proposed role(s):
__________________________
Optional Team Member
___________________________
Role
__________________________
Optional Team Member
___________________________
Role
__________________________
Optional Team Member
___________________________
Role
__________________________
Optional Team Member
___________________________
Role
__________________________
Optional Team Member
___________________________
Role
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Part V
Narrative
Please answer the following questions in narrative form and attach your narrative to your application.
Applications without narratives will not be accepted. There is no minimum, nor maximum, requirement on
length for the narrative, though care should be taken to ensure that all questions are answered completely and
accurately. Please remember that this narrative should be completed by your school’s principal, though
other team members may attach letters of support.
Narrative Questions
1. What excites you most about Pacific Symphony’s Class Act program?
2. As you know, Class Act offers multiple levels of participation, with Level II serving as the most popular
level among current Class Act schools. Please share why you feel your first choice would be a good “fit”
for your school and what you hope to achieve by having your school community participate at this level.
If you have listed a 2nd or 3rd choice, please address why you feel these choices would be a good “fit” for
your school and what you hope to achieve by having your school community participate these levels.
3. Please explain the role you would see Class Act playing in relation to your school and district’s current
music program. If your school does not have a music program, please describe the role you would see
Class Act playing in relation to your district’s music program and/or Class Act’s role in building an
emerging music program.
4. Include a brief description of your school community, including demographic detail.
5. Class Act is a volunteer-based program with support needed from Principals, Parent Coordinators, and
Teacher Representatives. How will your school administrators, teachers, and parents work together to
support the Class Act program in your school?
6. How will your school work with the Pacific Symphony to increase awareness of, and promote, Class Act
within your school and local community? How will your school work with the Pacific Symphony to
increase awareness of, and promote, other Pacific Symphony opportunities including concerts and
Education offerings?
7. What else would you like for us to know about your school?
8. How did you learn about Class Act? Do you have any proposed team members who have participated in
Class Act in the past?
9. Do you have any questions about the program you would like addressed before moving forward with your
application process?
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