MDCC Band Audition Form

Name*

First Name

Initial (optional)

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone*

Email (most used)*

Date of Birth*

What marching instrument do you play? *

What concert instrument do you play?*

Do you need an instrument provided?*

Yes No

What High School do you currently attend?*

If you graduated or are a transfer student, what school did you recently attend?*

What is your ACT score?*

Select which audition date you plan to attend: (select one)*

What time of day do you prefer to audition? (select one)*

Do you plan to live on campus?*

Yes No

Would you like a campus tour on your audition day?*

Yes No

What division do you wish to tour?*

How many people will be with you on the tour?*

Notice of Non-Discrimination Statement

Mississippi Delta Community College does not discriminate on the basis of age, race, color, national origin, religion, sex, sexual orientation, gender identity or expression, physical or mental disability, pregnancy, or veteran status in its educational programs and activities or in its employment practices. The following person has been designated to handle inquiries regarding the non-discrimination policies: Dr. Steven J. Jones, Vice President of Administrative Services, Tanner Hall, Suite 202, P. O. Box 668, Moorhead, MS 38761, 662-246-6304; EEOC@msdelta.edu.