Music Department Prospective Student
Music Information Form

Thank you for your interest in Bethany College! You will receive email confirmation within three working days. If you do not receive confirmation, please call 1-800-826-2281 ext. 8235 for assistance.

NOTE:This form is not an official college application.
This form will be used by the Music Department staff to help determine prospective student-musicians.
Items marked with and asterisk* are required.

 

Personal Information

*Last Name *First Name  Middle I.    Gender (M//F) 
*Street Address  *City  , *State  *Zip 
Country       *Home Phone #
Your E-mail Address   
Parent's E-mail Address
*Date of Birth (mo/day/yr) *Date of Grad (mo/yr) 
Ethnic Background (optional) 
*High School Name  *Year in School (FR/SO/JU/SR) 
*Address 
*City  , *State  *Zip  *Phone 

Vocal Music Instructor Name

Band/Choir/Orchestra Director Name 

Music Background
Primary Instrument: (If voice, what range?)
Secondary Instrument(s):
Other interests:
Did you participate in any of these events? Check, if so.

H. S. Band
H. S. Choir
H. S. Orchestra
First Chair/Section Leader
Regional/State Solo (select all that apply)
      voice
      instrument
      piano

Jazz Ensemble
Jazz or Show Choir
Lions State Band
Summer Music Camp
Church Music (select all that apply)
      choir
      organist
      pianist    

 
Ensemble Contests
Madrigal/Select Ensemble
All League Honor Group (select all that apply)
      choir
      band
      orchestra      		Study Privately
On what instrument?
How long?
Currently?
District Honor Group
State Honor Group
Solo/Ensemble Accompanist
MTA/Piano Guild Activities		  

If other, please list:
Other information you would like to share:
Interest Level
Please select the level that represents your present interest in Bethany.
Other Colleges of Interest 
Do you intend to apply for financial assistance to attend college (optional).  Yes  No
                        

   
Bethany College
335 E. Swensson Street
Lindsborg, Kansas 67456-1897

Telephone: 1-785-227-3311 or 3380 x 8113
Admissions Fax: 1-785-227-8993
Admissions Telephone: 1-800-826-2281

 Copyright © 2006 Bethany College
Last Modified: October 31, 2008