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

High School Programs

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2017 High School Award Nomination Form

Award Category:

Instrument or Vocal? *REQUIRED

Instrument/Voice Part: *REQUIRED

Award Recipient Information:

Student First Name: *REQUIRED

Student Last Name: *REQUIRED

Address: *REQUIRED

City: *REQUIRED

State: *REQUIRED

Zip Code: *REQUIRED

Grade (this year): *REQUIRED

Parent/Guardian Name: *REQUIRED

Nominating Teacher Information:

Teacher Name: *REQUIRED

Teacher Title: *REQUIRED

Teacher Phone: *REQUIRED

Teacher Email: *REQUIRED

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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? *REQUIRED

Award Presentation Event:

Event Name: *REQUIRED

Date: *REQUIRED

Time: *REQUIRED

Location: *REQUIRED

Student's Qualities:

If you are requesting that a Civic Music representative make the presentation at your awards event or concert, please describe the student's qualities by completing this form or by writing a letter that describes the following qualities.

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Scholarship:

Leadership:

Musicianship:

School Service:

Other Notable Achievements:

Please submit by May 22, 2017 and at least 7-10 business days prior to your event (preferably by email). Civic Music Association 2625 S. Greeley Street, Suite 3A Milwaukee, WI 53207 (414) 483-3223 / info@civicmusicmilwaukee.org