Apply for the Fellowship Grant ~ Positive Vibrations Foundation

Applicant Name * First Last
Applicant's Personal Email Address *
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone Number ### - ### - ####
Applicant's Personal Cell Phone ### - ### - ####
Facebook Username
Twitter Username
Birthdate
(MM/DD/YYYY) You must be between 14 and 17 at the start of the program.
Languages spoken
School Info
Name of School
Grade You Are Entering Next Fall
GPA to date
Type of School
Magnet Charter Art School Public Catholic Other
School Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
School Phone Number ### - ### - ####
Music Instructor / Director
Music Instructor / Director's Phone Number ### - ### - ####
Music Instructor / Director's Email Address
School Website
Upload a PDF copy of your school report card for the 2010-2011 school year:
Uploaded file:

Grant Applicant Written Questions & Bio

All questions must be answered to be eligible for grant consideration.
Type or write a 500 word BIO, or autobiography.

Total word Count : 0
Please rank the follow music opportunities you are most interested in studying right now: (1 being most important and 3 being least important)
Instrumentation/Vocal/Performing 1 2 3

Song writing 1 2 3

Producing 1 2 3

Other, please explain:
This is a four week arts and cultural intensive summer program for young musicians, song writers, musical producers held in New Orleans, Louisiana. Tell us your experience with travel and cultural studies and what interest you about this program:
What 5 groups or recording artists are you listening to the most right now?
What are your musical influences and how were you introduced to them?
Primary Instrument
Other Instruments Played
Please list ensembles you have performed with, include school orchestras, jazz groups, garage bands, church choir, or other.
Please list all the pieces you have studied intensively and which you consider to be a part of your repertoire.
Please list all songs you are prepared perform before a live audience.
Please list all venues you have performed in; school concert, church, coffee house, open mic night, special events or other.
Volunteer and Community Service Experience 1
Organization Name
Organization Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Organization Phone Number ### - ### - ####
Dates Served
Supervisor / Coordinator Name
Email Address
Website
Describe Your Service Activities
Service and Volunteer Experience 2
Organization Name
Organization Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Organization Phone Number ### - ### - ####
Dates Served
Supervisor / Coordinator Name
Email Address
Website
Describe Your Service Activities
Pay It Forward Project
Fellowship recipients are required to deliver a Pay it Forward project. These are service projects developed in partnership with the foundation. If awarded a fellowship grant you would commit to taking on a challenge of improving a condition in your home community.

Make a pitch of the project you may like to pursue that would involve identifying an issue in your community and how you would like to improve the condition.

Primary Contact / Parent / Guardian Info

To be filled out by primary contact
Relationship to Grant Applicant
Does Grant Applicant live with primary contact?
Yes No
Primary Contact Name First Last
Primary Contact Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Primary Contact Home Phone ### - ### - ####
Primary Contact Work Phone ### - ### - ####
Primary Contact Mobile Phone ### - ### - ####
Primary Contact Email Addres
Primary Contact Marital Status
Primary Contact Occupation
Primary Contact Occupation Status
Full Time Part Time Unemployed
Primary Contact Languages Spoken
Why do you want your son or daughter to be awarded this fellowship and what do you expect him or her to gain from the experience?
Secondary Contact, Parent 2 or Guardian

To be filled out by secondary contact
Secondary Contact's Relationship to Grant Applicant
Does Grant Applicant live with secondary contact?
Yes No
Secondary Contact Name First Last
Secondary Contact Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Secondary Contact Home Phone ### - ### - ####
Secondary Contact Work Phone ### - ### - ####
Secondary Contact Mobile Phone ### - ### - ####
Secondary Contact Email Addres
Secondary Contact Marital Status
Secondary Contact Occupation
Secondary Contact Occupation Status
Full Time Part Time Unemployed
Secondary Contact Languages Spoken
Why do you want your son or daughter to be awarded this fellowship and what do you expect him or her to gain from the experience?

Music Reference
To be completed by a music related reference, such as a music teacher, songwriting teacher, theatre director, studio engineer, or music related mentor reference. Nomination may not be made by a family member.

Enter their email address:

Go To Part 5

Fellowship Nomination Form #1
Relationship to Grant Applicant
Your Name Title First Last Suffix
Institution
Title / Position
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Work Phone Number ### - ### - ####
Mobile Phone Number ### - ### - ####
Email Address
Describe the situation in which you know the applicant
How long have you known the applicant?
Relationship
Music Instructor/teacher Ensemble conductor/director Private lesson instructor Mentor Other
Relationships - Individual and Others

According to your knowledge of the applicant's personality and character, please rate this applicant in terms of his/her qualities:
	No Basis	Below Avg	Avg	Above Avg	Excellent (top 10%)	Outstanding (top 5%)	Outstanding (top 1%)
Overall achievement	1	2	3	4	5	6	7
Intellectual promise	1	2	3	4	5	6	7
Quality of performance	1	2	3	4	5	6	7
Creative, original thought	1	2	3	4	5	6	7
Productive discussion	1	2	3	4	5	6	7
Respect accorded to facility	1	2	3	4	5	6	7
Disciplined work habits	1	2	3	4	5	6	7
Maturity	1	2	3	4	5	6	7
Motivation	1	2	3	4	5	6	7
Leadership qualities	1	2	3	4	5	6	7
Integrity	1	2	3	4	5	6	7
Reaction to setbacks	1	2	3	4	5	6	7
Concern for others	1	2	3	4	5	6	7
Self-confidence	1	2	3	4	5	6	7
Initiative, independence	1	2	3	4	5	6	7
Works well with others	1	2	3	4	5	6	7
Can follow directions	1	2	3	4	5	6	7
Difficulty working with others	1	2	3	4	5	6	7
Problem solver	1	2	3	4	5	6	7
Can take constructive criticism	1	2	3	4	5	6	7
Independent Thinker	1	2	3	4	5	6	7
Respects Elders	1	2	3	4	5	6	7
Communication skills with others	1	2	3	4	5	6	7
Communication with people from different backgrounds	1	2	3	4	5	6	7
OVERALL	1	2	3	4	5	6	7

Musical Performance

According to your knowledge of the applicant's personality and character, please rate this applicant in terms of his/her qualities:
	No Basis	Below Avg	Avg	Above Avg	Excellent (top 10%)	Outstanding (top 5%)	Outstanding (top 1%)
Dependability	1	2	3	4	5	6	7
Leadership Skills	1	2	3	4	5	6	7
Ability to work with a group	1	2	3	4	5	6	7
Ability to work alone	1	2	3	4	5	6	7
Integrity	1	2	3	4	5	6	7
Self-confidence	1	2	3	4	5	6	7
Independent	1	2	3	4	5	6	7
Creative	1	2	3	4	5	6	7
Practices daily	1	2	3	4	5	6	7
Comes prepared to sessions	1	2	3	4	5	6	7
Basic Talent	1	2	3	4	5	6	7
Technique Rhythmic	1	2	3	4	5	6	7
Sense Musicality	1	2	3	4	5	6	7
Intonation	1	2	3	4	5	6	7
Sight Reading	1	2	3	4	5	6	7
Potential	1	2	3	4	5	6	7
Receptivity to new music	1	2	3	4	5	6	7
Picks up new music	1	2	3	4	5	6	7
Song writing/Composing abilities	1	2	3	4	5	6	7
Musical Production abilities	1	2	3	4	5	6	7
Performance abilities	1	2	3	4	5	6	7

How competent is this applicant as demonstrated by his/her musical performance in school and/or community?
Outstanding performance Above average performance Satisfactory Below average performance Unsatisfactory performance
Emotional Maturity (age appropriate). Please describe your impression of the student's ability to work and adapt in challenging and changing situations
Please describe what you think is important for us to know about this applicant and what distinguishes him/her from others.
This is the last question. Are you finished with all of your responses, and do you hereby certify that the information provided in this grant award nomination is accurate and complete to the best of your knowledge?
Yes No
Save My Progress / Submit

Character Reference
To be completed by a teacher (non-music), mentor, clergy, volunteer supervisor, employer or other adult that has worked with you in a leadership capacity and can comment on your character. Nomination may not be made by a family member.

Enter their email address:

Go To Final Step

Fellowship Nomination Form #2
Relationship
Teacher (other than music or creative) Mentor Clergy Employer Volunteer supervisor Other
Your Name Title First Last Suffix
Institution
Title / Position
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Work Phone Number ### - ### - ####
Mobile Phone Number ### - ### - ####
Email Address
Describe the situation in which you know the applicant
How long have you known the applicant?
Relationships - Individual and Others

According to your knowledge of the applicant's personality and character, please rate this applicant in terms of his/her qualities:
	No Basis	Below Avg	Avg	Above Avg	Excellent (top 10%)	Outstanding (top 5%)	Outstanding (top 1%)
Overall achievement	1	2	3	4	5	6	7
Intellectual promise	1	2	3	4	5	6	7
Quality of performance	1	2	3	4	5	6	7
Creative, original thought	1	2	3	4	5	6	7
Productive discussion	1	2	3	4	5	6	7
Respect accorded to facility	1	2	3	4	5	6	7
Disciplined work habits	1	2	3	4	5	6	7
Maturity	1	2	3	4	5	6	7
Motivation	1	2	3	4	5	6	7
Leadership qualities	1	2	3	4	5	6	7
Integrity	1	2	3	4	5	6	7
Reaction to setbacks	1	2	3	4	5	6	7
Concern for others	1	2	3	4	5	6	7
Self-confidence	1	2	3	4	5	6	7
Initiative, independence	1	2	3	4	5	6	7
Works well with others	1	2	3	4	5	6	7
Can follow directions	1	2	3	4	5	6	7
Difficulty working with others	1	2	3	4	5	6	7
Problem solver	1	2	3	4	5	6	7
Can take constructive criticism	1	2	3	4	5	6	7
Independent Thinker	1	2	3	4	5	6	7
Respects Elders	1	2	3	4	5	6	7
Communication skills with others	1	2	3	4	5	6	7
Communication with people from different backgrounds	1	2	3	4	5	6	7
OVERALL	1	2	3	4	5	6	7

According to your knowledge of the applicant's personality and character, please rate this applicant in terms of his/her qualities:
	No Basis	Below Avg	Avg	Above Avg	Excellent (top 10%)	Outstanding (top 5%)	Outstanding (top 1%)
Dependability	1	2	3	4	5	6	7
Leadership Skills	1	2	3	4	5	6	7
Ability to work with a group	1	2	3	4	5	6	7
Ability to work alone	1	2	3	4	5	6	7
Integrity	1	2	3	4	5	6	7
Self-confidence	1	2	3	4	5	6	7
Independent	1	2	3	4	5	6	7
Creative	1	2	3	4	5	6	7
Comes prepared	1	2	3	4	5	6	7

What degree does the candidate participate in community service volunteer projects?
How competent is this applicant as demonstrated by his/her community participation and involvement?
Outstanding performance Above average performance Satisfactory Below average performance Unsatisfactory performance
Emotional Maturity (age appropriate). Please describe your impression of the student's ability to work and adapt in challenging and changing situations
Is the applicant empathetic to the issues and needs of others in their community? How have they taken initiative to participate in service minded organizations to improve the conditions.
Please describe what you think is important for us to know about this applicant and what distinguishes him/her from others.
I recommend this student for the Positive Vibrations Foundation fellowship:
Not at all Moderately Highly Very Highly
This is the last question. Are you finished with all of your responses, and do you hereby certify that the information provided in this grant award nomination is accurate and complete to the best of your knowledge?
Yes No
Save My Progress / Submit

Thank you for your submission.

Positive Vibrations Foundation Admissions Committee

Please save your progress before leaving.

Are you finished with the application? And have you sent in the above materials?

Yes (please click "Save My Progress" after checking 'Yes') No

Grant Application

School Info

Grant Applicant Written Questions & Bio

Volunteer and Community Service Experience 1

Service and Volunteer Experience 2

Pay It Forward Project

Primary Contact / Parent / Guardian Info

Secondary Contact, Parent 2 or Guardian

Fellowship Nomination Form #1

Relationships - Individual and Others

Musical Performance

Fellowship Nomination Form #2

Relationships - Individual and Others