Your Name

Address (Street, City, State, Zip)

Email Address

Telephone

Country of Citizenship

If not a US citizen, are you a permanent resident? If not a US citizen, are you a permanent resident? Yes No

Names and address(es) of parents or guardians

HIgh School Name and Address

Current Grade Point Average

Extracurricular Activities

Community Service

Honors & Awards

Personal Interests & Hobbies

List any special reasons that may influence your receiving a scholarship

How did you learn about this scholarship?

List any work experience (date, employer name, responsibilities, and hours worked per week)

Describe your music background (list your teachers, areas of study, dates, and representative composition learned)

List any awards or recognition you have received in music

What initially brought you to music?

Why have you chosen to major in music?

What do you think you may be doing 10 years from now, and what part will music play in your life?

Please list in order of preference the colleges/universities to which you have applied (name, city/state, and if you've been accepted)

Your Name

Name of music professional who will submit a reference for you

Two additional references (name, address, phone, and relationship to you)