ALCORN STATE UNIVERSITY BAND APPLICATION
1000 ASU Drive #270
Alcorn State, MS 39096-7500
Phone: (601) 877-6263     Fax: (601) 877-6262
Email: griffin@lorman.alcorn.edu 

(please print and return)


Personal Information


Name_________________________________________________________________

Address_______________________________ Phone# __________________________

City/State/Zip___________________________________________________________

Social Security No.____________________      Instrument_________________________

Age __________        Grade _________        GPA _________             ACT Score _______

Gender: Male__________ Female__________ Proposed major _______________________

Parent/Guardian Name__________________________________________________________

Address (if different) ________________________________________________________

Father's Occupation ________________________    Mother's Occupation ________________

High School ___________________________    Band Director's Name __________________

School Address _____________________________________________________________

Band Phone # __________________________

Musical Background

Years of private study ______   Teacher's Name _____________________________

Other instruments you play ______________________________________________

Music honors or awards ________________________________________________

Number of years of band experience _____________ Marching  _________ Concert

Chair position ______________   Part (1st - 2nd - 3rd - 4th)  ____________________

What instruments do you own? ___________________________________________

Number of years of singing experience ____________________