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Student Name*
Student Email*
Name of Parent/Guardian*
*If Student is Under 18
Parent/Guardian Email *
Student Phone *
Parent/Guardian Phone
Address - State -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Anticipated Start Date * Fall QuarterWinter QuarterSpring QuarterSummer Quarter
Gender - Please Select -MaleFemale
Date of Birth (DOB)
High School Name/Home School - State -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Grade Level (Can Choose More Than One) 1112Home SchoolHigh School GraduateCollege UndergraduateAdult (Life Long Learner)
Overall GPA
I Can Read Music NotationYesNo
I Play The Following Instruments VocalKeyboardWoodwindBrassPercussionStings
May Choose More Than One
I understand that this registration form is for admission only for the term indicated. I agree that I am bound by the Colleges regulations concerning application deadlines and admission requirements. I agree to the release of any transcripts. I understand that making false or fraudulent statements within this application or residency statement will result in disciplinary action, denial of admission, and invalidation of credit or degrees earned. If admitted, I agree to abide by the policies of the American College of Music Board of Trustees and the rules and regulations stated in the College's Catalog. Should any information change before entering the College's Extension Learning Program, I will notify the Office of Admissions. I understand that the application fee I submit with this application is non-refundable.
Do you understand and agree to the terms listed above? * Yes, I understand, agree to the terms listed above, and is at least 18 years old.No, I am not 18 years old
Student Signature *
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Parent/Guardian *
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