DEPARTMENT OF MUSIC

QUESTIONNAIRE FOR APPLICANTS

FALL 2009

PLEASE TYPE OR PRINT CLEARLY

Name: Last ____________________________________ First ___________________________________ Middle ____________________

Address: ________________________________________________ City: _______________________ State: ______ Zip: _____________

Phone: ___________________________ Email: _________________________________

Intended Area of Concentration: (prioritize by indicating 1-3; 1 representing your first choice)

Performance________ Composition_______ Music Education_________

Experience:

List major experiences in music as a performer, composer/arranger, conductor, teacher, etc. (type of activity & role)

Repertoire (Performance & Music Education only)

List a few representative works which indicate your level of proficiency and versatility as a musician

SOLO:

ENSEMBLE:

Goals and Interests

What are your professional/career goals?

What extracurricular interests do you have?

Personal Statement

Please provide any ADDITIONAL information about yourself which you feel might be helpful in reviewing your application for admission to the UCLA music major. This statement should be typed or printed on 8 1/2" x 11" paper and should not exceed two pages. ATTACH your statement to this questionnaire. You may submit a copy of the essay included with your UC application or write a new personal statement.

PRIVACY NOTICE

The California Information Privacy Act requires the University to list the following information for individuals who are asked to provide information about themselves.

1. The principal purpose for requesting the enclosed information is to consider your application for admission to the UCLA Department of Music.

2. This information is solicited in accordance with University policy, adopted pursuant to Article IX, Section 9 of the California Constitution.

3. Failure to furnish each item of information will delay or may prevent completion of the purpose for which this questionnaire is intended.

4. Information furnished in this questionnaire may be used by various University departments and may be transmitted to State and Federal goverment agencies if required by law.

5. This questionnaire is maintained by the Student Services Office of the UCLA Department of Music, Schoenberg Music Building, Los Angeles, CA 90095.-1616