Undergraduate Music Application

Please fill in the number of years you have participated and whether you did so privately or in a class. Indicate school and church ensemble experience as a class.

Instrument 1

Instrument:

Years Played:

Type of Study:

Instrument 2

Instrument:

Years Played:

Type of Study:

Instrument 3

Instrument:

Years Played:

Type of Study:

Instrument 4

Instrument:

Years Played:

Type of Study

Instrument 5

Instrument:

Years Played:

Type of Study:

Please list your additional instruments here including the number of years played and the type of study.

References

Please list the name and email address of two musicians who have sufficient knowledge of your training to evaluate your qualifications for a major in music. If you are studying privately, please include the name of your current or most recent teacher. Note: parents may not fill out a recommendation unless they are your direct supervisor or teacher in school.

Reference 1

Reference Name

Reference Email Address

Reference 2

Reference Name

Reference Email Address

Certification

I certify that all information requested on this application is correct, that the opinions supplied are mine, and that the Greatbatch School of Music has my permission to contact the individuals listed in the reference section for recommendations with regard to my admission.

Signature (please type your name as your signature)