High School Band Day

Which best describes you?

First-Year Student (includes students who have taken CCP classes)

Transfer Student

Student's Legal First Name

Student's Preferred First Name

Student's Last Name

Student's Birthdate

Primary Citizenship

Student's Home Address

Country

Street

City

Region

Postal Code

Student's Mobile Phone (include area code)
By submitting a mobile phone number, you agree to receive text messages from Heidelberg University

Student's Email
Since many schools block emails from outside senders, please use a personal email address instead of a school-issued one

Would you like to provide a Parent or Guardian email address to receive a confirmation email?

Yes

No

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian relationship to you

What year do you expect to begin your college studies?

Are you interested in another academic program?

Yes

No

Which age group(s) are you interested in teaching?

Pre-Kindergarten through Five (PK-5)

Fourth through Nine (4-9)

Seven through Twelve (7-12)

What excites you about your academic program?

High School Name

High School Graduation Year

Current or Most Recent College Name

Please let us know the total number of guests we should expect, including the student?

Is there anything else you would like to learn or experience during your visit that isn’t covered on this form? If so, please let us know.

What instrument will you be playing for Band Day?

Please let us know if you or your guests require any special accommodations to ensure a comfortable experience

Please provide any additional details regarding your accommodation needs