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  • Men'S Basketball Questionnaire: Contact Information

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    Joseph R. Couch
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    This document appears to be an application for a music scholarship at Doane College. It requests contact information from the applicant, including name, address, phone numbers, and email. It also asks for family, academic, and music information such as GPA, ACT score, instrument or voice part, and audition pieces. At the end, it provides upcoming audition dates and asks the applicant to select a preferred date and time.

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    21110

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    This document appears to be an application for a music scholarship at Doane College. It requests contact information from the applicant, including name, address, phone numbers, and email. It also asks for family, academic, and music information such as GPA, ACT score, instrument or voice part, and audition pieces. At the end, it provides upcoming audition dates and asks the applicant to select a preferred date and time.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    14 views1 page

    Men'S Basketball Questionnaire: Contact Information

    Uploaded by

    Joseph R. Couch
    This document appears to be an application for a music scholarship at Doane College. It requests contact information from the applicant, including name, address, phone numbers, and email. It also asks for family, academic, and music information such as GPA, ACT score, instrument or voice part, and audition pieces. At the end, it provides upcoming audition dates and asks the applicant to select a preferred date and time.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    P L ISC A

    N EF T
    OB
    R AS L
    CL
    H OQ
    LU
    A RESSHT
    I PI O
    I NN M
    MAEP N
    BTAI O
    SK
    NUASIIRC E

    Contact Information: (Please Print)


    Joseph
    Romanos
    Couch
    Joseph
    Name____________________________________________________________________________________________________________

    First

    Middle

    Last

    Preferred

    S 3rd
    Address__539
    _________________________________________________________________________________________________________

    Seward
    Nebraska
    68434
    City_________________________________________________________
    State __________________
    ZIP Code_ ____________________

    couch.joseph@gmail.com
    E-mail ___________________________________________________________________________________________________________
    402 __643-9625
    Home Telephone (____)
    _________________________________

    402 641-6322
    Cell Telephone (____)________________________________

    Family Information:
    Richard Curtis Couch
    Elizabeth Couch
    Name(s)_____________________________________________________
    /_ __Cathleen
    __________________________________________________

    Painter
    Manager
    Occupation(s)________________________________________________
    /_ __Walmart
    __________________________________________________

    (402)643-2893 Alma Mater(s) _____________________ /___________________________
    (402)525-5822
    Business Phone(s)____________________/_
    _______________

    Kelcy TappDoane alumni/students whom you know_________________________________________________________________________


    Elizabeth Couch, George Couch, Nicholas Couch, Rebekah Couch
    Sibling(s)_________________________________________________________________________________________________________

    Academic Information:
    05/13/2012
    Seward High School/ Concordia University
    High School/College____________________________________________________
    Graduation Date___________________________

    3.77
    41
    121
    31
    Grade Point Average ______________
    Class Rank/No. in Class_________
    /________
    ACT/SAT Score__________________________
    No
    Do you plan to major in music?____________________
    If yes, please check your anticipated area(s) of concentration below:

    Education
    Performance
    Other_______________________________
    Mathmatics

    If no, please list your anticipated college major:____________________________________________________
    No
    Are you pursuing any other extracurricular scholarships at Doane College? Yes

    If yes, which one(s):____________________________________________________________________________

    Music Information:
    I am primarily a: Vocalist

    Instrumentalist

    I plan to audition for (check all that apply):



    Tenor
    Vocal Scholarship - list voice part__

    _____________________________________________________________

    Instrumental Scholarship - list principal instrument_______________________________________________

    Piano Scholarship

    List piece(s) to be performed for audition:


    Alessandro Scarlatti
    Sento Nel Core

    Title:______________________________________________________
    Composer:______________________________________
    Wayfaring
    Stranger
    John Jacob Miles
    Title:______________________________________________________ Composer:______________________________________
    Will you need an accompanist? Yes
    No
    (If yes, email your music to audition@doane.edu at least one week prior to audition. Include your name and audition date in subject line.)

    Open Audition Dates:

    Select date and time preference for your Scholarship in Music audition. Upon receipt of this form, you will receive a confirmation
    letter with the scheduled time of your audition. Additional audition times can be arranged on an individual basis. Please contact
    the Office of Admission with any questions by calling 402.826.8641 or toll-free 800.333.6263.


    Tuesday, February 7, 2012
    Monday, February 13, 2012

    Tuesday, February 21, 2012

    Save File - Email as Attachment

    Friday, February 24, 2012


    Saturday, February 25, 2012

    Preferred audition time:

    Send to: suzy.cochnar@doane.edu

    AM PM
    Reset the Form

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