2013 Student Admission Application

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:

  • Parent(s)/Guardian(s) name(s), address(es), phone(s) and email(s)
  • Method by which you plan to submit your audition
  • School Band Director's name, school address, phone and email
  • Private Teacher's name, address, phone and email
  • Youth Orchestra or other non-school performing organization's name, address and phone; and conductor's name and email
  • Details about your musical background, including recent pieces played and awards won
  • A parent or guardian to sign the form (unless 18 or older)

Questions? Please contact our Registrar at 920-868-3763 or mainoffice@birchcreek.org for assistance.

* Indicates a required field

Today's Date*

Session(s) applying for*

Prior attendance at Birch Creek?*

If yes, what year(s)?

Jazz Applicants: IF YES, were you in the
Which combo?

How did you hear about us?

If other, please tell us where you heard about us:


First Name*     Last Name*


Address* Address 2

City*     State*     Zip*

Date of birth* / /

Home phone w/area code*     E-mail*

Mother/Legal Guardian

First Name     Last Name

Address Address 2

City     State     Zip

Home phone w/area code     E-mail

Check if financial statements should be sent here

Father/Legal Guardian

First Name     Last Name

Address Address 2

City     State     Zip

Home phone w/area code     E-mail

Check if financial statements should be sent here

We prefer to receive notices by:


Additional Applicant Information

Instrument applying for*

Secondary instrument

I intend to submit my audition recording by the following means:*

If you already have a live audition set up, who is the audition with?
Audition date:

Teacher Information

Name of High School*

High School Music Teacher First Name     Last Name

Teacher Phone     E-mail

High School Address* Address 2

City*     State*     Zip*

Private Music Instructor Information

Private Music Instructor First Name     Last Name

Phone     E-mail

Home Address Address 2

City     State     Zip

Music Organizations Outside of School

Do you belong to a youth orchestra or other performing organization outside of school? If yes, please provide:

Organization Name     Director/Conductor

Phone     E-mail

Organization Address Address 2

City     State     Zip

All Applicants - The following information is REQUIRED of all applicants.

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.*

Nonrefundable Processing Fee

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:*

If paying online, click here to go to our payment page. (opens in a new window)

General conditions of attendance:

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.*

Financial Aid

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:

Applicant Recommendations

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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