MSM Summer 2017 Application
Application Due Date: January 9, 2017
Application Instructions
Please read all instructions carefully to complete your application. Incomplete applications will not be processed.

In addition to the online application, the following items below are needed to complete your application for MSM Summer 2017.

1). NON-REFUNDABLE APPLICATION FEE (new applicants only)
$50 application fee for NEW applicants only.
$75 ($50 plus $25 late fee) application fee for applications submitted after January 9, 2017.

Application fee must be paid by CHECK for domestic applicants or CREDIT CARD for international applicants.

Domestic applicants paying by CHECK:
Please make check payable to Manhattan School of Music with the applicant's name and instrument in the memo portion. Checks not filled out properly will be returned.

Mail your check to:
Manhattan School of Music
Attn: MSM Summer
120 Claremont Ave
New York, NY 10027

International applicants paying by CREDIT CARD:
Please download the credit card form at www.msmnyc.edu/camp.

Cash and money orders will NOT be accepted.

Application fees are non-refundable.

2). REFERENCE LETTER (new applicants only)
All NEW applicants must submit one (1) reference letter from a teacher.

Reference letters for new applicants should be emailed to summercamp@msmnyc.edu.

All reference letters must be submitted by the person giving the reference and NOT by the applicant.

3). BEHAVIORAL HEALTH PROFILE (residential applications only)
New and returning applicants who are applying for the RESIDENTIAL program must submit a behavioral health profile.

Download the behavioral health profile form at www.msmnyc.edu/camp.

Section I: Audition Information
Please check one: *
Download the audition requirements at www.msmnyc.edu/camp.
Section II: Enrollment Information
Have you ever attended MSM Summer in the past? *
If so, did you attend MSM Summer 2016?
I would like to enroll in: *
Section III: Applicant Information
Last Name *
Your answer
First Name *
Your answer
Preferred Name
Your answer
Gender Identity *
Street Address *
Your answer
Apartment Number
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Country *
Your answer
Applicant's Email Address *
Your answer
Primary Telephone Number *
Your answer
Secondary Phone Number (if applicable)
Your answer
Applicant's Date of Birth *
MM
/
DD
/
YYYY
Age you will be on July 1, 2017 *
Current Grade *
Your answer
Citizenship *
Your answer
Ethnicity *
Required
Instrument(s) for which you are auditioning to MSM Summer: *
Check all that apply. If you are auditioning on more than 1 instrument you will be scheduled for additional audition times.
Required
Number of years you have studied/ played your instrument *
Your answer
Name of Applicant's School *
Your answer
Please choose what type of school it is. *
School Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Country *
Your answer
How did you hear about MSM Summer? *
Your answer
Section IV: Parent/Guardian Information
Parent/ Guardian #1's Last Name *
Your answer
Parent/ Guardian's #1's First Name *
Your answer
Parent/ Guardian #1's Email Address *
Your answer
Parent/ Guardian #1's Primary Phone Number *
Your answer
This is the applicant's: *
Parent/ Guardian #2's Last Name
Your answer
Parent/ Guardian #2's First Name
Your answer
Parent/ Guardian's #2's Email Address
Your answer
Parent/ Guardian #2's Primary Phone Number
Your answer
This is the applicant's:
Emergency Contact Last Name *
Your answer
Emergency Contact First Name *
Your answer
Emergency Contact's Relationship to Applicant *
Your answer
Emergency Contact's Primary Phone Number *
Your answer
In accordance with the Family Education Rights and Privacy Act of 1974, you have the right to withhold the disclosure of any or all information including the applicant's name, parent's name, address, and phone number.
Section V: Application Materials Checklist
In addition to the online application, all materials listed below must be received by January 9, 2017.
1). Application fee: $50 *
New applicants only. $75 application fee for late applications submitted after January 9, 2017. Please make checks payable to Manhattan School of Music with the applicant's name and instrument in the memo portion of the check.
Required
2). Reference Letter *
New applicants only. Submit one (1) reference letter from a teacher by email.
Required
3). Behavioral Health Profile *
New and returning residential applicants must complete the Behavioral Health Form.
Section VI: Signature from Parent/Guardian
Electronic Signature *
Required
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