Music Interest Form

* denotes required field

First Name*

Preferred Name

Last Name*

Email Address*

Birthdate*

School you currently attend (Please select from the drop down menu as you begin typing)*

School CEEB Code

If you have music performance experience, please list it here: (District or All-State experience, leadership roles in ensembles, membership in ensembles, auditioned groups, solos, lessons, etc)

Would you be interested in participating in music performance at Merrimack College?*