Admission

Prospective Student-Musician Questionnaire

Please tell us about yourself.
*Required Fields
Student First Name*
Student Last Name*
Sex* Male  Female
Applying For Grade* 9   10   11   12   PG
Date of Entry* Fall 2008  Fall 2009
Home Address*
Street Address*
Apt. No., Box No., etc (if necessary)
City*, State*, zip (postal code)*
Phone Number*
E-Mail*
Date of Birth -- mm/dd/yy
Are you applying for financial aid? no   yes
 
Current School*
How did you first learn about NMH?*
Please list interests in order of priority
Instrument/Voice #1
Years of Study
Ensembles with this instrument/voice
School Music Teacher
School Music Teacher's Phone Number
Private Music Teacher
Private Music Teacher's Phone Number
Instrument/Voice #2 (if any)
Years of Study
Ensembles with this instrument/voice
School Music Teacher
School Music Teacher's Phone Number
Private Music Teacher
Private Music Teacher's Phone Number
Instrument/Voice #3 (if any)
Years of Study
Ensembles with this instrument/voice
School Music Teacher
School Music Teacher's Phone Number
Private Music Teacher
Private Music Teacher's Phone Number
Other extracurricular interests:

 

Refer Questions or Comments to:

Steven Bathory-Peeler
413-498-3263
Music Department
Northfield Mount Hermon School
One Lamplighter Way
Mount Hermon, MA 01354


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