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* 1. Your name

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* 2. Name of organisation / school

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* 3. Region your organisation / school covers

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* 4. What might you include in your special Ten Pieces assembly (let us know if you have any specific music groups with your school, special projects you would like to include)

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* 5. Are you happy for a member of the BBC Ten Pieces or BBC Music Day team to be in touch about this activity?

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* 6. If you answered yes to question 5 please give school email and phone contact details (please do not give personal details).

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