Math, Science and Technology Conference

Prospective Musician Information Sheet

The music faculty at Phillips Exeter Academy is pleased that you are interested in our school and participating in the music program. To help us get to know you better, please take a few moments to fill out the information form pertaining to your musical interest(s). You will not receive a response to this submission, but a faculty member will review the form.

* Indicates Required Fields

General Information:

First name: *
Last name: *
Address one:
Address two:
Address three:
City/Township:
State/Province:  (US/Canada only)
Zip/Postal code:
Country: *
 
Email: *
Confirm email: *
Phone:
 
Current School: *
Current grade level: *
Birthdate: *  
 
If you have scheduled a tour and/or interview with the Phillips Exeter Academy admissions office, what date will that be:  

Music Background:  

Primary instrument: *   Specify if other: 
Years of study:
 
Secondary instrument:   Specify if other: 
Years of study:
 
Please tell us where you study music: 
 
Please list the name of your teacher(s): 
 
Please list pieces you have been practicing or performing recently: 
One:
Two:
Three:
 
Please list your ensemble experience (i.e. orchestra, chorus, band) and indicate the number of years you have participated: 
 
Please tell us anything more you would like us to know about your musical activities: