| Please fill out the following form completely. |
[Section 1: Personal Information] |
| Name: |
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| Gender: |
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| Date of Birth: |
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| Permanent Address: |
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| Home Phone: |
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| Mobile Phone: |
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| E-Mail: |
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| Parent E-Mail: |
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Please indicate if you need overnight housing:
Residential ($500)
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| Father's name: |
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| Living: |
Yes
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No |
Father's Address
(If different than above): |
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| Mother's name: |
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| Living: |
Yes
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No |
Mother's Address
(If different than above): |
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| High School: |
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| Graduation Date: |
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| GPA: |
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High School Address
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| High School Phone: |
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| Church Name: |
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| Name of Minister: |
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| Name of Youth Minister: |
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| Member: |
Yes |
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No |
Church's Address
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| Church Phone: |
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Are you interested in Dual Enrollment credit for this program?
(If so, we will send more information.) |
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Yes
No |
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| High School
students are eligible for 1 credit hour of dual enrollment
credit at no additional cost. (Credits are transferable to
the college of your choice.) Tennessee residents may qualify
for a grant through the Tennessee Lottery program to help
pay for the cost of your program, but must apply for the
grant by May 1. Call 800.262.8337 or email
artsacademy@milligan.edu to learn more. |
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[Section 2: Academic Interests] |
| Please tell us what potential academic major(s) you are interested in when you enroll in college. |
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[Section 3: Activities & Leadership] |
| Please list activities in which you have participated or held leadership at school, church, or in the community. |
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[Section 4: Experience] |
| Please complete the following section only for the program you plan to attend. |
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| Please indicate your experience in each area: |
| (E-mail additional information if necessary) |
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| Digital Photography |
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| Briefly describe your experience: |
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| Video |
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| Briefly describe your experience: |
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| Graphic Design |
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| Briefly describe your experience: |
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| List any awards, honors, notable projects or achievements in audio/visual, journalism, multimedia or film production: |
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| Which of the following is your specialty/primary area? |
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| Describe your level of experience: |
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| Please list any other instruments you play and your level of experience on each: |
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| Do you study privately? |
Yes |
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No |
| If yes, how many years? |
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| Current Teacher: |
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| Teacher E-Mail: |
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| Teacher Phone: |
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Teacher Address:
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| What ensemble(s) do you currently participate in? |
| Ensemble Name: |
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| Director: |
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| Director E-Mail: |
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| Director Address: |
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| *Optional Secondary Ensemble |
| Ensemble Name: |
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| Director: |
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| Director E-Mail: |
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| Director Address: |
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| List any awards or honors you've received in music: |
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| Please list any theatre experience at school, church, or in the community (either on or off stage). |
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