Senior Scholarship Application

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Age at Audition *

Date of Birth *

Instrument *

Second Audition Piece (Composer, Selection and Movement) *

Years Studied *

School Now Attending *

Current Teacher's Name *

Current Teacher's Phone Number *

I have asked my teacher to email a recommendation to Michael Struck *

Yes No

I live at home with parents *

Yes No

Mother and/or Father's Full Name *

Upload resume of musical experience *

Max file size: 20MB

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