First Name:
Last Name:
Middle Initial:
Peoplesoft Number: Provided at Orientation - if you don't have yours yet, write "NOT RECEIVED,"

HOME ADDRESS:
Street:
City:    
State:  AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY             Zip Code:
Date of Birth:
Home Phone Number:                  Cell Phone Number:
Campus Address:                 Campus Phone Number:
Email (most commonly used) :
Screen Name:
Home Newspaper:
High School:
H.S. Band Director:
High School Positions:
Years as:    Drum Major: choose one 1 2 3 4     Section Leader: choose one 1 2 3 4
High School Awards:
Years in:    All-Regional Band: choose one 1 2 3 4     All-State Band: choose one 1 2 3 4

University Classification as of Fall 2008: choose one Freshman Sophomore Junior Senior Graduate
Major:
Primary Instrument/Colorguard:
Other Instruments:
H.S. Marching Experience: choose one No Marching Experience Non-Competitive High School Competitive High School DCI - Drum/Bugle Corps
Uniform Size Information: Does not need to be exact - used primarily to ensure we have the right number of uniform parts.
Height: inches
Weight: lbs
Waist: inches
Chest: inches
Inseam: inches

Do you receive Work Study as part of your financial aid package? Yes No
UConn Awards and Activities:

Any other information you wish the UCMB to know:

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