Music Theory College Intensive Application FormLoading...Please complete the form below to apply for the Winter Music Theory College Intensive! The application deadline for this course is December 1, 2020. Once you submit this form, you'll receive an email notification within one week letting you know if you've been accepted. It is recommended that applicants for this class are comfortable with reading music in treble and bass clefs, key signatures, and basic chords/harmonies. Please email Intensives@cim.edu with any questions.Student InformationStudent TypeChild (Under 18)Adult (Over 18)First NameLast NameBirthdateBirthdateJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember1234567891011121314151617181920212223242526272829303120242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900Preferred Pronouns:He/Him/HisShe/Her/HersThey/Them/Theirsxe/xem/xirsxe/xem/xyrsze/hir/hirsze/zir/zirsNo pronouns (just use my name)My preferred pronouns are:Students under the age of 18 must enter at least ONE parent/guardian below:AuntGrandparentParentPartnerSiblingStep-ParentUncleLegal GuardianSpouseOtherParent/Guardian First NameParent/Guardian Last NameParent/Guardian Email AddressParent/Guardian Phone NumberContact InformationStudent Email Address (this will be the primary email we use to send important communications)Student Primary Phone NumberMailing AddressMailing AddressCountryStreetCityRegionPostal CodeMusical BackgroundLevel of Education (for the 2019-2020 school year)High SchoolUndergraduateSchool Currently Attending:Current Grade (Fall 2020)9101112Are you taking private lessons on an instrument, voice or music theory?Are you taking private lessons on an instrument, voice or music theory?YesNoPlease select your primary instrument:Baritone SaxophoneBass ClarinetBass TromboneBassoonCelloClarinetCompositionDouble BassEuphoniumEurhythmicsFluteFrench HornGuitarHarpMusic TheoryOboeOrganPercussionPianoPiccoloSaxophoneSuzuki CelloSuzuki Double BassSuzuki PianoSuzuki ViolaSuzuki ViolinTenor SaxophoneTenor TromboneTrumpetTubaViolaViolinVoiceUnknownPrivate Teacher NamePrivate Teacher EmailPlease describe your music theory and instrumental background/experience. Please include information about any private lessons, classes or ensembles you have previously participated in, as well as the theory topics you have covered:Are you comfortable reading treble clef?Are you comfortable reading treble clef?YesSomewhatNoAre you comfortable reading bass clef?Are you comfortable reading bass clef?YesSomewhatNoAre you comfortable identifying basic chords?Are you comfortable identifying basic chords?YesSomewhatNoPlease list any unavoidable conflicts that may interfere with the intensive for which you are applying - if none, please enter "none"MiscellaneousHow did you hear about this course?How did you hear about this course?CIM AlumniEnsemble ConductorFacebookFriendInstagramInternet SearchNews ArticleOther CIM EventOther Social MediaPrint AdvertisingPrivate TeacherPromotional EmailsSchool Counselor/Academic AdvisorTwitterWebsite or BlogYouTubeOtherPlease Describe:Equal Opportunity Policy In the administration of its educational and admission policies, scholarship, loan, and other school-administered programs, the Cleveland Institute of Music is committed to nondiscrimination and equal opportunity. The Institute admits students to all the rights, privileges, programs, and activities generally accorded or made available to students at the school regardless of race, color, national or ethnic origin, citizenship, religion, age, sex, sexual orientation, or disability. The Cleveland Institute of Music is in compliance with Titles VI and VII of the Civil Rights Act of 1964, Title IX of the Educational Amendments of 1972, and Section 504 of the Rehabilitation Act of 1973. Complains regarding alleged institutional discrimination, harassment and misconduct should be addressed to the Title IX Coordinator, Tamatha Belton, Director of Human Resources, 11021 East Boulevard, Cleveland, OH 44106. 216.791.5000.Submit