2017-18 Gluck Fellow Information Form: Classroom, Ensemble, Family Learning, GluckGlobal, OPA! Fellows (Form 4)
This form is for ALL fellows. Fellows, when you have been notified of your selection as a Gluck Fellow, please complete this information form. Due: August 1 for Classroom Fellows, additional due dates for other Fellows.
ALL Gluck Fellows: Classroom, Ensemble, Family Learning, GluckGlobal, OPA!
This form is for ALL Fellows and must be complete before scheduling.
Last Name
Your answer
First Name
Your answer
SID #
Student Identification number - starts with 86. This is NOT your Social Security number.
Your answer
Are you a US Citizen or International Student?
International Students are required to set their tax status in Banner and Glacier, please speak to your Financial Aid advisor.
Class
Department
What department are you doing your degree with?
Your answer
Gluck Program Title / Ensemble Name
Your answer
Stage Name
If you would like us to use an alternative name in our advertising and promotion, please let us know.
Your answer
Preferred Gender Pronoun
Your answer
Email Address
Your answer
Cell Phone Number
Your answer
If you went to school in the Inland Empire, please tell us the names of your schools
Your answer
Brief Biography
Write in 3rd Person and include your major, minor, educational background, if you are a returning Gluck Fellow, etc.
Your answer
Submit
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