Name:
Email Address:
Address
City
State/Zip Code
Country (if not USA)
Phone
Primary Instrument/Voice Type	Bass (Acoustic) Bass (Electric) Bassoon Cello Clarinet Euphonium Flute French Horn Guitar (Classical) Guitar (Jazz/Commercial) Harp Oboe Organ Percussion (Classical) Percussion (Jazz/Commercial) Piano Saxophone (Soprano) Saxophone (Alto) Saxophone (Tenor) Saxophone (Baritone) Trombone Trumpet Tuba Violin Viola Voice (Soprano) Voice (Alto/Mezzo) Voice (Tenor) Voice (Bass/Baritone)
Secondary Instrument/Voice Type	None Bass (Acoustic) Bass (Electric) Bassoon Cello Clarinet Euphonium Flute French Horn Guitar (Classical) Guitar (Jazz/Commercial) Harp Oboe Organ Percussion (Classical) Percussion (Jazz/Commercial) Piano Saxophone (Soprano) Saxophone (Alto) Saxophone (Tenor) Saxophone (Baritone) Trombone Trumpet Tuba Violin Viola Voice (Soprano) Voice (Alto/Mezzo) Voice (Tenor) Voice (Bass/Baritone)
High School Attended
Year Graduated
Are you a Transfer Student?	Yes No
If so, from where?
Area/Degree Program of Interest	B.M. Music Education B.M. Music Performance (Voice Emphasis) B.M. Music Performance (Instrumental Emphasis) B.M. Music Performance (Piano Pedagogy Emphasis) B.M. Music Performance (Jazz Emphasis) B.A. Music Music Composition Studies Piano Pedagogy Certificate Minor in Music Ensemble Participation Not Sure at this Time
Send me information on NKU's Music program	Yes No
Please have a member of the faculty representing my area of interest contact me.	Yes No
Comments or Specific Questions?

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