Student Name:

Age:

Parent / Guardian:

School Name:

Directors Name:

Grade:

Student Phone:

Instrument:

Doubling Ability:

(select all that apply)

Yes

No

Has student taken private lessons?

If yes, how long?

List of Honors and outside ensembles:

Student Rating: Tone (please rate your student 5 highest - 1 lowest)

5

4

3

2

Student Rating: Range (please rate your student 5 highest - 1 lowest)

Student Rating: Technique (please rate your student 5 highest - 1 lowest)

Student Rating: Musicality (please rate your student 5 highest - 1 lowest)

Student Rating: Cooperation (please rate your student 5 highest - 1 lowest)

Student Rating: Solo Ability (please rate your student 5 highest - 1 lowest)

1

Director Reccomendation:

Has this student been selected for this group before?

Yes

No

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