NOTE: This form cannot save your progress; please complete and submit the entire form before leaving this page or closing your browser. It may be helpful to assemble all of the necessary information before you begin. You will need:
Questions? Please contact our Registrar at 920-868-3763 or firstname.lastname@example.org for assistance.
* Indicates a required field
Session(s) applying for*
Symphony June 24 - July 6, 2013 Percussion & Steel Band July 8 - 20, 2013 Jazz I July 22 - Aug. 3, 2013 Jazz II Aug. 5 - 17, 2013
Prior attendance at Birch Creek?* ---YesNo
If yes, what year(s)?
Jazz Applicants: IF YES, were you in the Lab Band Studio Band
How did you hear about us?
Internet Magazine ad Private teacher School music teacher Friend/relative Birch Creek student Other
If other, please tell us where you heard about us:
First Name* Last Name*
City* State* Zip*
Date of birth* ---010203040506070809101112 / ---12345678910111213141516171819202122232425262728293031 / ---19921993199419951996199719981999200020012002
Home phone w/area code* E-mail*
First Name Last Name
City State Zip
Home phone w/area code E-mail
Check if financial statements should be sent here Yes
We prefer to receive notices by:
Instrument applying for* ---ViolinViolaCelloString BassFluteOboeClarinetAlto SaxophoneTenor SaxophoneBaritone SaxophoneBassoonFrench HornTrumpetTromboneTubaHarpPianoGuitarBass GuitarPercussionSteel Pan
I intend to submit my audition recording by the following means:* ---I wish to upload digital audition file(s) (Birch Creek will send you an email with instructions)I have arranged a live audition (specify with whom and when, below)I will mail my audition recordingI am exempt from the Admission audition requirement
If you already have a live audition set up, who is the audition with? ---Castañeda, Ricardo (Oboe)De Salvo, Jodie (Piano)Everson, Robert (Percussion)Fairfield, Laura (Horn)Finney, Shannon (Flute)Gaudette, John (Bassoon)Gauthier, Renée-Paule (Violin)Gerth, Jennifer (Clarinet)Henry Liebenow, Marcia (Violin)Lee, Matt (Trumpet)Mantell, Emily (Cello)Mantell, Matt (Viola)Seeman, Faye (Harp)Stark, Tom (Trombone)Steiner, Alan (String Bass)
Name of High School*
High School Music Teacher First Name Last Name
Teacher Phone E-mail
Private Music Instructor First Name Last Name
Do you belong to a youth orchestra or other performing organization outside of school? If yes, please provide:
Organization Name Director/Conductor
Please tell us about your musical background. Include how long you have been playing, your musical education, experiences and goals. You may also attach a musical resume in PDF or Word format (please note "file attached" in the area below).*
List any notable music or academic achievements or awards.*
Please list a few pieces/jazz standards you have been playing during the last year.*
Please list several recordings that you are currently listening to or that have had an influence on your musical outlook.*
Please list several musicians who have influenced your playing. (This may or may not include people who play your instrument.)*
Please list pieces you have recently played in your orchestra, band and/or jazz band.*
There will be a $50 nonrefundable processing fee for each application. (PLEASE NOTE: Your application will not be processed or considered "complete" until payment is received).
Please indicate payment method:*
---For faster processing: I will pay online via credit/debit card, checking account, or savings accountI will mail a check or money order (send payment payable to: Birch Creek, Attn: Registrar, P.O. Box 230, Egg Harbor, WI 54209-0230)
If paying online, click here to go to our payment page. (opens in a new window)
As a student at Birch Creek, I, (insert your name*), will abide by all Birch Creek policies and regulations as set forth in my acceptance materials. I understand that a violation of these policies and regulations may be grounds for expulsion without a return of fees.*
I, (insert parent/guardian name*), parent/guardian of above named student understand that a violation of these policies and regulations may be grounds for expulsion of my student without a return of fees.*
Birch Creek offers financial aid to help musicians further their artistic development. Approximately 30% of our students receive some assistance. Awards are based on financial need and merit. Please contact our Registrar for a financial aid application, or fill out our online financial aid application. Financial aid applications will be reviewed after the student has been formally accepted and all required financial documentation and the audition recording has been received.
I intend to apply for financial aid:
Yes No Undecided
Please have a teacher familiar with your musical background and abilities (see Student Application & Program Materials for guidelines by session) complete and return the Applicant Recommendation Form:
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Mail to: Birch Creek Registrar, P.O. Box 230, Egg Harbor, WI 54209-0230
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Fax to: Birch Creek Registrar, 920-868-1643