VBODA Sidney Berg Scholarship Application

Name __________________________________________________________________________

Student's Major Instrument _________________________________________________________

Address ________________________________________________________________________

City _______________________________________________State______ Zip Code __________

Telephone ____________________ Email Address ______________________________________

High School Attending ____________________________________________________________

Principal's Name _________________________Email Address ___________________________

School Address __________________________________________________________________

City ____________________________________________State ______ Zip Code ____________

School Telephone ___________________ School Email Address ___________________________

Instrumental Director's Name ______________________ Email Address ____________________

Director's Telephone __________________Director's Fax Number _________________________

Father's Full Name __________________________________________

Mother's Full Name _________________________________________

MUSIC HONORS STUDENT HAS RECEIVED

All-State Band	Year ______	Chair ______	All-District Band	Year _____	Chair ______
	Year ______	Chair ______		Year _____	Chair ______
	Year ______	Chair ______		Year _____	Chair ______
	Year ______	Chair ______		Year _____	Chair ______
All-State Orchestra	Year ______	Chair ______	All-Regional Orchestra	Year _____	Chair ______
	Year ______	Chair ______		Year _____	Chair ______
	Year ______	Chair ______		Year _____	Chair ______
	Year ______	Chair ______		Year _____	Chair ______

Other National or Local Ensembles oustide of school

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Literature Studied or Performed

Work	Composer/Arranger	Grade of Literature
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Academic Honors

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Leadership

Band, Orchestra, School, Community (i.e. - officer, section leader, etc.)

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