Student Information

 ID #  

 First Name  

 Last Name  

 Address (include zip code)  

 Phone #  

 Student E-mail  

 Same Address as Mother?  

  Circle one - Yes or No

 Same Address as Father?  

  Circle one - Yes or No

 Grade  

  Circle one - 6th 7th 8th

 Gender  (male, female)

 T-Shirt Size (adult sizes only)  

  Circle one - S M L XL Other

 High School to attend  

  Circle one – Stevens HS Warren HS Other

Parent/Guardian Information

 Mother/Guardian First Name  

 Mother/Guardian Last Name  

 Work Phone #  

 Cell Phone #  

 Address (if different)  

 Mother E-mail  

 Father/Guardian First Name  

 Father/Guardian Last Name  

 Work Phone #  

 Cell Phone #  

 Address (if different)  

 Father E-mail  

For Band Director Use Only  

Tone (40 points)  

Instrument

Technique (40 points)  

Total Score

Musicality (20 points)  

Band Placement (WE or SB)