Student Request for Information

If you are a student who is interested in the UW-L Music Department and would like more information we'd love to hear from you. Please fill out and submit the form below and we will contact you soon with more information. Thanks!

Name:

Street Address:

City:

State: Zip Code:

Phone Number:

E-mail Address:

Date of High School Graduation:

ACT Score: Class Rank:

High School:

High School Director:

Private Teacher:

Primary Instrument / Voice Classification:

Secondary Instrument / Voice Classification (not required):

Areas of Interest (Select all that Apply):

Voice / Choir	Orchestra
Theory / Composition	Marching Band
Instrumental Jazz Ensemble	Concert Band / Wind Ensemble
Vocal Jazz	Piano

Intended Major:

Intended Minor: