Prospective Student/Music Scholarship Application
(please type or print clearly)

Student Information                                                                        Audition Date & Time                                             

Name

Social Security #

Home Phone # 

E-Mail Address 

Street                                                            City                                                State              Zip

Conway Address (if known)

High School Graduation Date

When do you plan to enter UCA?

Have you applied for admission to UCA?                                If yes, when?

Grade Point Average

ACT or TOEFL score

Classification Information

Freshman []        Sophomore []       Junior []       Senior []       Graduate Student []      Transfer from

Major performing medium (flute, piano, voice, etc.):

Secondary medium (flute, piano, voice, etc.):

Other interests:  small vocal ensemble []       jazz ensemble []        musical theater []        twirling/flags []
Probable field of study:  
               Bachelor of Arts degree []   
               Bachelor of Music degree in Performance []   
               Bachelor of Music degree in Education []

Student Achievements:  List some of your musical experiences and honors (orchestral, band, choral, etc.):

 

______________________________       
Signature of Applicant

Mail to:  
UCA Department of Music
201 Donaghey Avenue, Conway, AR 72035