& s s t k o a o B e H o o B ks SUMMER PROGRAM OPEN E R A S N O I T A APPLIC Enjoy a unique summer music and education program that strengthens academic performance using music as a basis for engagement. This program is designed for students entering grades 8 through 12. Students will have the opportunity to: • Explore cutting edge recording software, i.e. Pro Tools, Sibelius & Garage Band • Enjoy a Songwriter’s workshop conducted by a Grammy nominated National Recording Artist • Participate in master classes, lectures and demonstrations • Develop proficiency in computer technology • Produce finished CD and MP3 files to share digitally and publish online • Be introduced to Financial Literacy • Prepare a college portfolio • Participate in a mock music audition • Learn proper use of social media and other online tools, and Much More! Program Dates - Nine Days: Friday, June 26 Song writing Workshop with National Recording Artist Recital Hall, Bowie State University (Bus transportation provided from Oxon Hill High School to Bowie State) June 29 - July 2 & July 6 - 9 Oxon Hill High School 6701 Leyte Drive Oxon Hill, MD 20745 Registration Deadline: April 24, 2015 Registration & Information: www.fameorg.org [email protected] • 301.805.5358 Full scholarships are available for Prince George’s County students. Nomination Form required. This program made possible in part by funding from: Prince George’s County Community Partnership Grant; Prince George’s County Council Chair, Mel Franklin (District 9); Prince George’s County Council Vice Chair, Derrick Leon Davis (District 6), Prince George’s County Council Members: Deni Taveras (District 2), Todd Turner, (District 4), Andrea Harrison (District 5), Karen Toles (District 7), Obie Patterson (District 8) and United Way of the National Capital Area. APPLICATION The Beats Books & Hooks Summer Program is open to students entering grades 8 through 12. For information Visit: www.fameorg.org or Call 301-805-5358. A teacher nomination form is required for each applicant. Application closes April 10, 2015. Extended to April 24th PROGRAM DATES (9 days): June 26, 2015 – Song Writing Workshop at Bowie State University; June 29 – July 2 and July 6 – 9, 2015 at Oxon Hill High School. See Website for details. PART I: STUDENT & PARENT INFORMATION Last Name: First Name : Birth Date (Month/Date/Year): Home Phone: U.S. Citizen? State County Guardian 1: Relationship to Student: E-Mail Address Home Phone: Guardian 2: Relationship to Student: E-Mail Address Home Phone: Is either parent/guardian on active duty in the military? Female E-Mail Address: Home Address: City Male Age Yes No Zip/Postal Code Business Phone Cell Phone Business Phone Cell Phone If yes, which Branch of Service: EMERGENCY CONTACT (complete if different from Guardian) Name(s): Cell Phone: Work: Email Address: Home: Relationship to Student: Special instructions: PART II: SCHOOL & MUSIC TRAINING INFORMATION Name of Current School: City Grade Level: State Primary Instrument or Voice part: Other Instruments: County Current GPA: Zip/Postal Code What music software have you used? Please describe your musical background: How are you involved in your school’s music program? What would you like to learn during this program? How did you hear about this program? _____________________________________________ MEDICAL, FIELD TRIP & PHOTOGRAPHY CONSENT 1. I authorize FAME, when I cannot be reached, to take my child to the emergency room of the nearest hospital, at my expense, and the hospital has my authorization to provide treatment that a physician deems necessary for the well-being of my child. 2. I give permission for my child to be taken on field trips, off the Campus supervised by staff, whether by foot, metro, van or bus. I hereby release and hold harmless the school, its agents and employees, from all claims, damages or other liabilities for injuries to the student that are not the result of gross negligence by the school, its agents or employees. 3. I hereby authorize and give full consent to FAME to publish and copyright all photographs in which my child appears while enrolled. I agree that FAME may use photographs, videos, written extractions, and voice recordings of my child for the purpose of illustrations, publications and websites. 4. I hereby approve the foregoing and affirm that I have the legal right to issue such consent. Parent/Guardian Signature ____________________________________Phone # ____________________ Date: __________________ Please return your application and nomination form by March 31, 2015 April 24th via Email: [email protected], Mail: FAME, P O Box 2228, Bowie, MD 20718-2228 or Fax: 240-554-1555. NOMINATION FORM FAME’s Beats Books & Hooks Summer Program is designed for students entering grades 8 through 12. Nomination form should be completed by applicant’s music teacher. Nominations are due by April 10, 2015 NOMINEE/APPLICATNT INFORMATION: (Please submit a separate form for each student) Nominee’s Name: ____________________________________________________________________________________ First Middle Initial Last School Name ______________________________________________ Current Grade Level: __ 7___ 8 ___9 ___10___ 11 School Address ____________________________________________ City/State/Zip: ______________________________ NOMINATOR’S INFORMATION: Nominator’s Name ____________________________________________________________________________________ Job Title / Relationship to Nominee: _____________________________. I have known the nominee for _____ years/Months. School/Organization (if different from nominee) __________________________________________________________________ Address: _____________________________________________________ City/State/Zip: __________________________ Email ____________________________________ Office/School Phone________________ Cell ____________________ Musical Ability Excellent Technical Skill � Good � Average � Below Average Unable to rate � � Rhythm � � � � � Musicality � � � � � Sight Reading � � � � � Creativity � � � � � Personal Qualities Timeliness � � � � � Focus/Discipline � � � � � Cooperation � � � � � Social Maturity � � � � � Leadership � � � � � Additional Comments? _____________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ (Please continue on back if needed) Is the nominee aware that you are submitting this information? ________ What is the best time to call you if we need to discuss the applicant ____________ Nominator’s Signature ______________________________________________ Date ____ / _____ / ________ ______________________________________________________________________________________________________ Email nomination form to: [email protected], put “Summer Nomination Form” on subject line; or Mail form to: FAME Summer Program, P O Box 2228, Bowie, MD 20718 If you require more information, please visit our website, www.fameorg.org, or call us at 301-805-5358.
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