Text extracted via OCR from the original document. May contain errors from the scanning process.
I
I
S
I
About This Form
.00
(te
a et
Applicant Information
International students: When
providing telephone number,
include the country code and
the city code before the
local telephone number.
Application for Admission 4241t1V011,1416D
Please answer all questions below. The application deadline for first priority review is February it Application
this date arc welcome and will be reviewed on a rolling admission basis. Sec the "Admissions" section of the Cam
tor complete application and scholarship/financial aid information. Sorry, but we cannot process an incomplete al
I Yes RIND Are you applying for Scholarshipfinsneial Aid?
❑Yes EtNo Arc you applying foe Tx Governor's Scholar
Whst Division an
im for?
aim Session A
[Junior Setslong
O
on... A g
'ammo/art
O High Set
I
ate
NuntiOni4blen
Ser Moe F
Nome &your school.
Street Address
O
Yes
E
SN° Have you previously attendedI
ri Yes
l27 No Is a patent an alumni of Intuit:else:if K Esther
O Mother: Mtuden none:
Write alto attended:
Yeatfs) of attenclanct:
Additional International
Applicant Information
[YrYes
O No Are you a US. Cow&
If not a U.S.Gwen indicate edaenstop Sxkl
It English the pommy language spoken as home
tell Name
outset penal in the ani
atm
If nor. what is the psi
or,
TM
•
available')
Parent or Guardian
Information
D Stepfather
O Stepmother
O Legal Gunshot U Ocher.
Ic t O Monad
O Dintrced
OST•Thlld
(h&c 1
Arc. Code
puher m Guatdian (note relationship) N
I Inme Street Address
OcrupatIOn
Occupation
State
Zip
Name of F.mployer
(Ace Telephone: Area Code • Number
Office Far Arta Code . Number
Personal Information
Nmc any physical, psychnlogstal. medical ix other condition wolfing special at tau inn or care (such as sleepwalking, leaf of storms. bed anteing, etc.).
tem,. 4nrnenal adttruniontsirh at h.( thr
u-nue nr Avg Irrinh e&Itiv milenedtclener tie
Please give any infix:won that might he helpful in guiding the educe:caul and personal *mitts-um of pour child.
For Internal Use
EFTA00090247
Private Lessons?
Names
C.
A at left.
B at right.
Students in the Junior Division will be assigned Elute periods of arts activities, including private kssons.Students who complete grade 6
have the option of selecting an additional am dais in place of land recreation. Pleat refer to the 'Junior Division' section in the Camp Extra
for a complete discussion of arts activities, daily class scheduling and prerequisites.
1. Session A
1-Session B
3. Session A
3. Session A
3. Session B
3. Session B
4. Soda, A
IL Session A
0 4 - 30-min. lessens. Instrument:
0 4 - 60-min. lessons. Instrument:
4. Session B
•
S. Session B
0 4 -
lenrart Instrument:
0 4 -60-min. lenont Mummery:
Intermediate & High
School Arts Activities
Major Activity:
At left; list Course Names
in order of preference.
Minor Activities:
At right; list Count Names
in order of preference.
Private Lessons?
Music Students
Please Answer:
Students in the Intermediate Division will be assigned four periods darts activities, including private lessons. Students who complete grade 9
have the option of se.ecting an additional class in place of recreation. High cthani
L
--- -
r
including private Lessons. Please refer to your division's section in the
ing, prerequisites and audition requirements. Nets: the Comp does
W
Choke Maass Coors:Nano / Instrument Of appl
llaSecoodeunce Major Car
/ Instrument (afapplkabk)
a
M US
C
th em
SKIMS Clone Major Count Name / lintrument (if applicable)
OPPE R TTA WORIcS1-10 P
VOCAL TECH tsl iOOFs
aiiInguri
this INSTRUMENT
3CL`°'MgsE
/ FLUTE
ODERA/ DAtJCE
5
Minor Course Name
❑8-30.rnin. pirate lessons. Instrument:
0 8 60.min. pirate lessons with one period °Futuna daily. Instrument:
-1 1A—Mann unmet Imaubawob rob
rioram:mrhihr lembumm.
Dance, Theatre, Visual Art
students - Please A ns
Pinup.' caper :tore in Or<imur Nurnhei of Yea,, / Posit ion
Previous tapertalle in Band: Nombre n(Yrst t, t
Lin
difficult marka performed in on
ra, band or in ensemble within the put year.
List the RWO mot difficult Sot
haw mastered on your primary imimmens or sung.
TCIEA THE/ ML
si- CAL TEAT.
Trai n
a.k-
'oulannwe imataDescribe rim" training and ex enem' in this atm,
Vor 3--aef
cos-Fun/the ac4-m9
provisa-lion
•
musical -4-heal-re
pe_r%rtrarces, yvlovi ks •
Additional
References given to whom?
Neappltrenn ram he processed
arrhord
riAmarivry of Appistmii
drtd Paint/Guarthatv.
Send Admission
Materials to:
08410Rat Applicant please indicate:
0 Asian American
0 Bbck/Aftroo American 0 Chicano0desient American
0 Porno Rican
0 Native American/American Indian gr enitoCauessian
0 Other. please specify:
I
1
3a
Card,' Card Name and Number
Expiration Due
Please enclose the required $
on. Sec page 2 of the Camp Extra for a complete discussion of Camp cost and
refund policy. Your check at payable c
You may use a credit card: VISA. MasterCard, Discover and American Express.
EFTA00090248
Part I
Applicant
Artistic Recommendation
Please complete the follow in items and [et tint that the person to whom you are giving this form fill out Part
by February 15 to t
Admissions Office. This recommendation should be comp
instnictor or director who is very fame tar wit your abilities in your particular arts area.
THEA 712 E ARTS 7M it s iC L
F:
•Far
yea
What if your primary .rev of interne? If MUSIC, Int instrument.
urn
bet,
Port II
Instructor
The above student is making application for admission to the Interlochen Arts Camp and is asking that you complete this
confidential recommendation form. By returning this form by February 15, you will insure a prompt review of
his or her application. All information given will be treated in a strictly confidential andprofessional manner b the Camp.
Please return the completed form promptly to: Admissions Office
If you have questions, please call the Admissions Office a
0 Please check if you would like to receive more information about Interlochen Center for the Arts and its year-round educational programs.
Estimate of applicant's success:
gVir:11 probihn be a suetnet uudrne. D Will probinty be an above smote student. D wi:i probably be an avenge student
0 May have some difficulty and should have saw<al guidance44rue captain below).
I n relation to others in the candidate's age group whom you have known, please check the appropriate bar for each item:
AMUCK Potential
EfOutstanding
0 Veg. Good
0 Avenge
0 Below Average
Actinic Achievement
®Outstanding
'.Very Good
0 Avenge
0 Mow Average
Work/Practice Habits
cal Oatuarthng
I J Very Good
0 Menge
0 Below Avenge
Initiative
ROuutanding
0 Very Good
0 Avenge
D Below Avenge
Cantivity
Outstanding
• 0 Very Good
0 Menge
D Below Average
Common Seem
)310untanding
0 Very Good
0 Average
D Below Avenge
Stvicanness of Purpose
Outstanding
0 Very Good
0 Average
0 Below Average
RC/C6041 (9 Criticism
XIOntuanding
0 Very Good
0 Average
0 Below Average
Self Diu Milne
laOutstanding
0
Very Good
0 Average
0 Mow Avenge
c..4
Hatt t.(. -I aica
tao-.J •
Ptes Compatibility
nq Outstanding
Stuawe
v.u , rV-r.ttsn1 .
0 Avenge
0 Below Average
0 Very Good
Conduct
rektitstanding
0 Very Good
D Arnie
K Below Average
Integrity
Woutstanding
0
Very Good
0 Avenge
0 Below Average
EFTA00090249
ants
Additional comments. positive or otherwise, which the Camp should review when considering the applicants acceptance.'
•
The Camp wishes to receive all information which will lead to a better understanding of the applicant and his other.
•
experience to date.
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•
Please send admission materials to:
By returning this form by February 15 you will insure a
prompt review of this student's application. The application is
not considered complete until this information is received.
Questions?
Please call the Admissions Office a
EFTA00090250
Past
Applicant
Academic Recommendation
Please complete the loll
r
sr that the person to whom you are giving this form fill out Pa
by February 15 to th
Admissions Office. This recommendation should be complet
your school who knows you well and is working with you in an academic classroom setting.
ECG RA
EAC HER
1 year
In what capacity haw you known tlw penon completing this
II
4wµ?
MEATRE Agirg MICA Ca/UWE
Whit o your primary area or interest? If music, list instrument
Part II
Teacher
The above student is making application for admission to the Interlochen Arts Camp and is asking that you complete this
confidential recommendation form. By returning this torn by February 15, you will insure a prompt review of
his or her application. All information given will be treated in a strictly confidential and professional manner by theCamp.
Please return the completed form promptly to: Admissions Office
If you have questions. please call the Admissions Office at
D Please check if you would '..ke to receive inure information about Interlochen Center fur the Arts and its year-round educational programs.
litna
Es
to of applicant's success;
will ptniubly to a asps-nor stuckrit. O will probably be in above average stockist.
O Will probably to an avenge stuckni.
C May have wow difficulty and should have scot's' guidance (Paw explain below).
In relation m others in the candidates age group whom you have known, please check the appropriate box for each item:
Academic Potential
i
suistanding
O Very Good
O Mont
D Below Average
Academic Achievement
V
Osutstanding
O very Good
O Average
D Below Average
Week/Practice !fables
n
Outstanding
O Very Good
K Avenge
D licks Avenge
Initiative
02Kuutanding
D Very Geed
O Average
D Below Average
Gunton lot Others
aZsiarding
K Very Good
O Average
O Below Avenge
Gammon Sense
Outstanding
O Very Good
O Average
O Below Average
Seriousness of Punose
Visitsranding
O Very Good
K Average
D Below Average
Reaction rot
ins
/lAntitand:ng
O Very Good
O Average
O Below Average
Self Ihseipline
Outstanding
O Very Good
O Average
O Moat Average
Net Gompotibslity
E1,4<aandeas
K Very Good
K Avenge
O &Iola Average
Conduct
Outstanding
O Very Good
O Average
O Below Average
Integrity
ywrxanling
O Very Good
O Average
O Below Average
Over Please...
EFTA00090251
m.nts
lignatur•
Additional comments, positive or otherwise, which the Camp should review when considering the applicant's acceptance.' •
The Camp wishes to receive all information which will lead to a better understanding of the applicant and his or hat
ability to fit i
ing situation.
2 74)
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"44. -741,4•#,I4eof-x-
Are-itel
fr otiedt
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ee -a) Me4fate) "-e-itieree.,e) __erne"
62-ate-e- Anad
Scare
Zip
Mice Pax: Awn Code • Numb,/
z.
L.
By returning this form by February a you will insure a
prompt review of this student's application. The application is
not considered complete until this information is received.
Please send admission materials to:
Admissions
Question?
Please call the Admissions Office MI.
EFTA00090252
EFTA00090253
EFTA00090254
1
a
-SYS
Nov 1 8 RECD
x4-
Application for Admission 'a674 is/19.6q950"
About This nal
Answer all questions below. The application deadline for first priority review IS February 15. Appli
this date are welcome and will be reviewed on a rolling admission basis. See the - Admissions- section of the
for complete application and financial aid information. Sorry, but we cannot process an incomplete application.
Applicant Information
Are youwipes for Poona& And' 0
Yes eNo
Hart you imbed foe The Goytisolo, Scholar Program, ❑Ye ErNo
International students: When
providing telephone number,
include the country code and
the city code before the
local telephone number.
Have you previously attended Interlochen Arts Camp (excluding All-State), 2<ea 0
No
Yeses) wended.
I
y
e
a
r
/
I
ly
ee•KRCI%a
then ages
Nunes of utters AM their ages.
Istornational
Applicants Only
Country of bath
Secondary Language (if any) spoken at borne
Full name a • contact sworn in the Unued Seams
Ham Telephone: Area Code - Number (Fax available))
Parent or Guardian
Information
Father or Guardian Meet relationship) Name
Occupation
Horne Sam Addresa
City
State
Zap
N_—.e d Employer
Office Telephone. Arm Ccde • Number
Office Fax: Area Code • Number
Personal Information
N...e; in) yinniod pircholopol. medical or other condition requiring spun] women or can (sax
ilenawallang. fear oh mars. bed wetting, etc
She aditthis Q4.4rernely well and qpickly,
.92W- wer+In and abut
and Is
How do you ftle your child in trestle of pascal Admit:mot, such as Li °elm scene ed self
. abdity. indef....name.. ere a te lt m
ei
dent
How do you rare your child in terms of wen] adratemeic, ErHas many fnends 0
Has few finis
Has cot woo doe foods
ErHas had close association with older children FVosanser children ahluktren Au or her own age
NO
Is Mere any phase of personal or social idiom...in which you hope Camp will sad'
Plea give any information that might be helpful in guiding the educational and petunia development of your child.
For Internal tifre
L26 iglysic
ACk •
Sch.FA
Amt
gee C
t'
/
ILK D
per iv
Tape
Video •
gag
Hal rtiner
i.I,d`c
1-20 iVic)
work
Pon so
•
• IA11000091
EFTA00090255
Private Lessons?
High School
Class Schedule
Major Courses:
At left: list Class Names
in order of preference.
Minor Courses:
At right: list Class Names in
order of preference.
Private Lessons?
Dance, Theatre &
Visual Art Students
VocALfrii4GENG
6 yea.
Teacher's Stress Address
City
Stat
What is your secondary instrument or interest'
Number of tearsStudied
Previous exp.-tense in Orchestra: Number of Years Pontoon
Flufe : I year
Previous experience in Bad: Number of Years I Postition
List two difficult worksts ued in orchestra. band or in ensemble within the paswar.
146411/. 114
begin Very ottliiry
yre . (.Tram rat
c'ci ri level of
mask)
List the two encsraanc.c solos youluve mastered orerour primary instrument or sung.
MUSICRL ThEi+ TRP .
blue. had accorkt oftnei4 of atifini expert era. T 50 +o "the
%Bat is your primary interne Describe previous training and experience in this area
School OCPrr-Et -tor rsos:ir and +VI extre "I've done Cosimerdets, meal pncor
rfzs
'"43 ing, ?lo.45 , S k its I .e+c • Dia been is blew Yer•• 'broad uvai
Junior and Intermediate
Class Schedule
Students in the Junior Division will be assigned three periods of classes. including private lessons. Students who complete grade 6 have the
option of selecting an additional class in place of land recreation. Intermediate Division students will be assigned four periods of <Lusts.
including private lessons. Students who complete grade 9 have the option of selecting an additional class in place of recreation. Please refer to
your division's section in the Camp Extra for a complete discussion of cltig. scheduling, prerequisites and audition requirements.
'"
C HORUS
p l
C.f-to Ru S
1. Session A (Intermediate: First Choice Major)
Session B (Intermediate: First Choice Major)
Please list Class Names
MUSK,' L TI4sA THE
in order of preference.
f. Session A (Intermediate: Second Choice Major/
„2 Session B (Intermediate: Second Choice Mr)
session A ac left
fi c?--49PERETTA
i 0
314L)H517C.ilattiSn".
„
0
Camp session B at right.
Te
..,N Session A
%.1- 4. Session A
4r Session B
,2' :;' Vocal_
cf-ENIQuEs
'-v--- VOC AL- TECHNIQUES
30 moDest\i DANCE. (minor)
1 9:-:-fri
ff ---
ebeiza DAI4CE. 6.14,0r)
DEaNINC.7 WIND CLASC- R-UTE s* s'
8 SEG( NNW& W I mr) CL-fIsS- FLUTE
S. Session A n
0 4 - 50-mM. lessons. Instrument:
qq-
o 4 • 60-min. lessons. Instrument:
0,4. 60-min. lessons. Inn
t:
'11- a ocasn ' A-
rha_4vr L-..) 1.2 ch Se ss t os_ I ( I
High School students will be assigned five periods of classes. including private lessons. Please refer to your division's section in the Camp Extra
for a complete discussion of classes, scheduling, prerequisites and audition requirements. Note: the Camp does not guarantee participation in
more than one major activity.
1. First Choice Major Course Name Instrument (if applicable)
S. Minor Cosine Name
2. Second Choice Major Count Name !mina:lent(ifapplicable)
2. Minor Course Name
3. Third Choice Major Course Name r Instrument (if applicable)
3. Minor Course Name
4. Minor Count Name
S. Minor Course Name
0 8-50-min. private lessons. Instrument:
K 8.-60.min. private lessons. Instnamenc
Additional
References given to whom?
No application can be
processed without the
signatures of Applicant
and Parent or Guardian.
Send Admission
Materials to:
adm:sainns C1nIee
Name a person in receipt of Artistic Recommendation form 'C."
Home Telephone: Area Code
Number
Name of person in receipt of Academic Recommendation form "D.'
Home Telephone: Area Code - Number
How did you Ent lent about Intrelochen•
Optional. Applicant please indicate:
K Asian American 0 MinsA/man Amer an 0 Chwano(Mexican American
CI Puerto Rican
Credit Cud Name and Number
Expiration Date
Please enclose the required
ion. See page 2 of the Camp Extra for a complete discussion of Camp cost and
refund policy. Your check is payableYou
may use a credit card: VISA, MasterCard. Discover and American Express.
EFTA00090256
Application for Admission sn
IN
About This Form
MAR 01 'Ma
Application Checklist
Please answer all questions below. Refer to the "Admissions" section of the Camp Extra (page 2) for complete application and
financial aid information. The application deadline for first priority review is February 15. Applications m
see warnme tnel will he reviewerl CM 2 MINIM
9rimittion
baths. Send all materials to: Admissions Office
Complete address and phone information are on the bac
Sony, but we cannot process an Incomplete application.
O
Completed Application and Course Selection Form
0
Application Form Signatures
0
522S. Application Fee
O Audition Materials Enclosed if Required (see your division's Course Descriptions in the Camp Extra).
Camp Application Fee
Signatures
,annig jfiflt4) ymr application
uitbsva the ',porn of Appliano
end ParntGuardian.
Please enclose the required $225. with your application. Make checks payable to
charge the application fee to VISA, MasterCard, Discover or American Express.
If you wish, you may
Credit Card Name and Number
Expiration Date
Print Card Holder Name
Card Holder Signature
•
Applicant Information
What
/IC you applying foe?
0
Junkie Session A
0
Junior Session B
0
Intermediate Session A
0
Intermediate Session B
Advanced String Quartet Institute (Session A-High School only)
0
Creative Writing Institute (Session B.High School only)
Non-U.S. students: When
providing telephone number,
include the country code and
the city code before the
local telephone number.
Date of this Application
State
r Arm Code • Number
Grade comp:sired by June.
Social Security Number
0
No Have you pervvoirily attended Interred's-fa Arts Camp (excluding All.State)? Write years attended
Fri end
How did you fine learn about Interlochene
Optional. Applicant please indicate:
0
Asian American
0
African American
O Native American
arCaucauan
0
Other, please specify:
2. 699,1, iqqc)
0 Mexican American
0
Puerto Rican
0
Asian
Citizenship
Information
If you arc not a U.S. Citizen,
please complete this section.
Country of Birth
Country issuing the passport you will use to travel
Full name of a contact person in the United States
Home Stmt Address
State
Zip
Home Telephone: Ares Code • Number
Fax Number. Area Cock - Number
Teacher Information
Name of current primary dittnritor in your,ti area.
Home Street Address
crzy
flitaktiVkar E -7-Arigik7oR
-
State
p
Home Telephone Area Code - Number
Fax Number. Area Code • Number
Office Telephone' Area Code • Number
For Internal Uinta
Sch/FA
N
Audition 14000;18I 5
T PALI CL
al a hi if-
ev•76.-L
MA)
/fai
EFTA00090257
Parent or Guardian
Information
Home Street Address
\tint
Employer and address
City
Stare
Zap
Off Telephone: Area Code • Number
Office Faa: Area Cade • Number
Financial Information
If you are applying for aid.
please fill our this section.
Mother or Guardian
Please Answer
Father or Guardian
PleasCAnswer
Please attach a copy
of your most recent
Federal Tax Form 1040
to this form.
At< yk, ..pplying for financial aid%O Yes
IWNo
Arc ycra Apr,:y:ng for The Governor's Scholar Program? O Yes
ZKo
Dora the student applying expect to be the recipient of any funds (scholarship. Bane. award or pnze) from any country. stare, organization or individual specifically
for attendance at the Interlochen Arts Camp% K Yes Er No
If yes. name the title of award. source of award and amoont.
What i
Earnings this pear.
Value of real estate.
Earnings this year.
Value of real estate.
Please note unusual expenses or circumstances you would like taken into
Choosing a Major
All Juniors (grades 5-6) are designated as General Arts
below. Intermediate Division (grades 6-9) and High Scl
only minor courses, your designated major will be Gent
programs in the Intermediate and High School Divisiol
The information below must be completed it
Junior
Please refer to the "Junior Division- section in the Camp
requisites and audition requirements.
1. Session A: Band or Siring Orchestra Imtrument
1. Session B: Band or Stnng Orchestra Instrument
Intermediate
Please enter the Major
Code from the Camp Extra
(i.e. DMODN or BCLAR-
INET)
Please refer to the "Intermediate Division- section in the Camp Extra for a complete discussion of major arts activities, course
codes, class scheduling, prerequisites and audition requirements.
I. Session A: (first choke major codennstnunent)
S. &nil= B: (first choice major code/instrument)
2. Session A: (second choke major codeinstrument)
2. Session B: (second choice major tedefinstrurnent)
High School
Please enter the Major and
Code from the Camp Extra.
(i.e. TMUCL OR OVIOLIN)
Please refer to the "High School Division- section in the Camp Extra for a complete discussion of major arts activities, daily class
scheduling,
prerequisites and audition requirements.
7W6arge PgioWcriew ) music& -rinuct_
L Fast Choice Major Course Name and Code
Instrument (if applicable)
saer ertenZ Moen.
2. Second Choke Major Course Name and Code
Instrument (if applicable)
3. Third Choice Manx Course Name and Code
Instrument (if applicable)
INT000049
EFTA00090258
Course Selection Form
About This Form
Applicant Name
This part of the application will be used for class registration. Your major will he determined through the Admissions process.
You do not need to indicate your major on this page. Please complete the appropriate section to indicate classes that you would
like in addition to your major.
First Name
Middle
Lug
Junior
Please list class names in
order of preference. Do not
list according to time. '
Remember to include all
classes since there are no
majors in this division.
Students in the Junior Division will be assigned three periods of arts activities, including private lessons. Students who complete
grade 6 have the option of selecting an additional arts class in place of land recreation. Please refer to the "Junior Division"
section in the Camp Extra for a complete discussion of classes, scheduling and prerequisites.
1..Saston A: (first choice area of interns)
I -Session B. (lint choke stn of insane)
Session A: (second choice arm cruxes's.)
2. Session B: (second Omer area al inteiels)
&Session A: (third choice)
3-Session B: (third choice)
4. Session A: (fourth choice)
4- Samuel B: (fourth choice)
5. Session A: (alternate choice)
0. Session B: (alternate choice)
Private Lessons
0 4- 30 minuet lemons. (Instrument)
0 4 30 minute lessons. (Inumunem)
0 4 . 60 minute lemons. (Instrument)
0 4 . 60 minute lessons. (Sacrament)
Poitnet Campers Only: Teacher preference for private lessons.
Former (simpers Only Teaches preference for pr.
lessons.
Internals!.
Please list only minor class
names in order of preference.
Do not list according to time.
Please note that most majors
will count as two periods
of classes.
Private Lessons
Students in the Intermediate Division will be assigned four periods of arts activities, including private lessons. Students who
complete grade 9 have the option of selecting an additional class in place of recreation. Please refer to the "Intermediate
Division" section in the Camp Extra for a complete discussion of classes, scheduling, prerequisites and audition requirements.
1. Setae A: (fiat choice)
1. Session B. (line chart)
2. Session A: (attend choice)
2. Seams B: (mad choice)
3. Session A: (third choice)
3. Session B: (third choice)
4. Session A. (alternate choice)
4. Session B: (alternate choice)
O 4 30 minute lessons. (Inutomms)
0 4.30 minute lessons. (Instrument)
O 4.60 minute lessons. (Instrument)
0 4 - 60 minute Irma fimuument)
O 4 .60 minute lessons with 2 ponds wage. (Instrumem)
0 4 - 60 minute lessons with 2 periods pactire.Onunienent)
Forme, Campers Only: Trochee prefennce for minor leuom.
Fan*. Campers Only Teacher preference for ptivase know..
High School
Please list only minor class
names in order of preference.
Do artist according to time.
Please note that most majors
will count as two periods of
classes.
Private Lessons
High School students will be assigned five periods of arts activities, including private lessons. Please refer to the "flesh School
Division" section in the Camp Extra for a complete discussion of classes, scheduling, prerequisites and audition requirements.
0 eereitit L110 r KS hr)
L Fi /Choice
1. First Altetnste
2. Second Choice
2. Second Alternate
3. Third enure
4. Founts Choice
.4., Voice soprano
80 8 - 30 immure lessons. (Instrumea)
0 8 - 30 minute lasom. (Baronet's)
C 8 - 30 minute lessons. (If second instrument)
0 8 • 30 minuet lessons. (If second Mt omen )
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Artistk Information
VOCAL - Softit 0
All students please answer:
Why is your primary instrumenr or incerest?
Number of Yean Studied
Music Students:
Personal Information
Describe previous training and experience in this um,
amt.< LRsr Yertos' eff..O2.Os eF
Pair Athetuemediv rS I
What is your secondary inurument or interest?
Number of Yeats Studied
Describe previous training end experience on this ant
Perrino experience in Orchestra: Number of Years / Pcsirion
Previous experience in Band: Number S Years I Position
Eat SWO difficult works performed in orchestra, band or in ernernble within the pant year.
Ak
th .04_ )$ 40CaelIclie-ULL14
Lin the two mew dais We solos you bat mutant on your primary *automats or sung.
Noce any
Weal* psysnDhigica l
(cal a other condition requiring special attention or careBuds as sleepwalking, feu obtains. bedwertinfi. etc.).
g
O
y
ne.
How do you rate your child in terms of personal admstrant, such as his or her sane of self worth, ability, independency. etc./
&t. reccnds and gioateLs ft-atil_last4leat's
How do you rue rut child in terms of social adjsureneno? WHea many friends 0
Has few friends 0 Hu one or two thaw friends
M ellen had close association wish *We children 63' Yowiter hildftn Erthildren his or her own age
No
Is there any phase of personal or social adjuwentat which you hope Camp will aid?
Plane give any infamous% that might be helpful in purling the educational ad personal developownt of your child.
Send all materials and
direct inquiries to:
When using U.S. Pond
Service tend so:
When wing Federal Express, UPS
and Airborne Express mad to:
MI=
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