Civic Music Association of Milwaukee : WHAT WE DO : High School Programs : High School Award Nomination Form

2018 High School Award Nomination Form

Instrument or Vocal? (Required)

Instrument/Voice Part: (Required)

Student First Name: (Required)

Student Last Name: (Required)

Address: (Required)

City: (Required)

State: (Required)

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Zip Code: (Required)

Grade (this year): (Required)

Parent/Guardian Name: (Required)

Teacher Name: (Required)

Teacher Title: (Required)

Teacher Phone: (Required)

Teacher Email: (Required)

May we add you to our monthly eNewsletter mailing list?

High School Name: (Required)

Address: (Required)

City: (Required)

State: (Required)

Zip Code: (Required)

School Principal Name:

School District Name:

Are you requesting that a representative from CIVIC MUSIC present this award?

Event Name: (Required)

Date:

Time: (Required)

Location: (Required)

Scholarship:

Leadership:

Musicianship:

School Service:

Other Notable Achievements:

Please submit by May 22 and at least 7-10 business days prior to your event.

2625 S. Greeley Street, Suite 3A Milwaukee, WI 53207 (414) 483-3223 / info@civicmusicmilwaukee.org