Student Nomination Form

Eugene Symphony is thrilled to announce private lesson scholarships are now available as part of our 2021/22 Private Lesson Program. We invite Bethel, Eugene, and Springfield public middle and high school music educators to nominate up to two (2) students to be considered for this program. Open to students of all ages and abilities.

Deadline to nominate students EXTENDED TO MONDAY, FEBRUARY 28, 2022.

Eligibility:
·Bethel, Eugene, and Springfield School Districts (public schools only)
·Middle and high school band and orchestra students 
·All ages and playing abilities welcome
·All orchestral instruments welcome (except piano)
·Available to students who do not have the opportunity to study with a private lesson teacher otherwise
·Participating students must be vaccinated against COVID-19 to participate. (Note: At the time of this announcement, all Teaching Artists are vaccinated against COVID-19)

FOCUS: This scholarship is available to students who otherwise do not have the opportunity to take private lessons. We welcome nominations for reliable students who display a positive attitude towards learning and will show up prepared for lessons.

Student Selection Process:
Fifty-five (55) scholarships will be awarded this year, twenty (20) of which will be via the NAACP Scholarship Opportunity outlined below. In contrast to last year, each school is not guaranteed to have a student participate. This year, student nominations will be reviewed according to the submitted nomination statement and NAACP scholarship eligibility. Students and teachers will be notified by e-mail of participation status in late February 2022. Final confirmation of the student’s participation in the program will be dependent on Eugene Symphony teaching artist availability and parent confirmation.

NAACP Scholarship Opportunity for BIPOC Students
Twenty (20) scholarships will be awarded to BIPOC students, specifically students from communities that have been historically underrepresented in classical music. The NAACP Scholarship Opportunity is generously funded in part by the Eugene/Springfield NAACP Branch #1119.

View the full announcement HERE.

Contact:
Katy Vizdal, Education & Community Engagement Director
Eugene Symphony Association
E-mail: katy.vizdal@eugenesymphony.org
Phone: 541-687-9487 x1116

Question Title

* 1. Teacher Name (Nominator):

Question Title

* 2. Title:

Question Title

* 3. School District:

Question Title

* 4. School:

Question Title

* 5. School Mailing Street Address:

Question Title

* 6. School City, State, Zip:

Question Title

* 7. Teacher Email Address:

Question Title

* 8. Teacher Phone Number:

Question Title

* 9. Student Name (Nominee):

Question Title

* 10. Student Instrument: (Please list one)

Question Title

* 11. Does the student have access to an instrument they can use at home?

Question Title

* 12. Student Grade Level:

Question Title

* 13. Music Program & Ensemble: (ex. 7th Grade Orchestra)

Question Title

* 14. Parent/Guardian Name:

Question Title

* 15. Parent/Guardian E-mail Address:

Question Title

* 16. Parent/Guardian Phone:

Question Title

* 17. Student Skill Level: (Beginner, Intermediate, Advanced)

Question Title

* 18. What level of music is your band or orchestra currently working on?

Question Title

* 19. Is this student keeping up with the music assigned in your classroom?

Question Title

* 20. Please indicate if this student has been vaccinated against COVID-19 at the time of this form submission.

Question Title

* 21. Please indicate if this student is eligible for NAACP Scholarship Opportunity (BIPOC students, specifically from communities that have been historically excluded from classical music)

Question Title

* 22. Please select all categories the student identifies as below: (optional) Eugene Symphony collects demographic information from program participants for program evaluation purposes.

Question Title

* 23. Nomination Statement: Why are you nominating this student for the Private Lesson Program? What impact would this scholarship have on the student's musicianship and as an individual? What are their musical ambitions; Do they plan to play in high school or college? Please speak to their enthusiasm to participate in this program. (400 max word count)

Question Title

* 24. If they are selected to participate, what would you like their new private lesson teacher to know about them?

Question Title

* 25. Is there anything else you feel we should know about the student you are nominating?

Question Title

* 26. Please list any questions you have here:

T