MusicLink Nomination Form and Student Talent Profile

Nomination Form (A)

All links between students and teachers of the MusicLink program require MusicLink registration through the MusicLink Foundation. Complete all information on this form and submit by clicking on the button at the bottom of the page.

Student Information

Student Name

First

Last

Date of Birth

Gender

Male
Female
Non-Binary

Grade

Instrument (First Choice)

Instrument (Second Choice)

Parent(s) or Guardian(s)

Name (Parent or Guardian)

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Email (Parent or Guardian)

Email 2

Home Phone

Office

Cell

For Office Use Only

MusicLink Teacher Name

MusicLink Teacher E-Mail

School/Organization Information

If the student was nominated by a school or organization,
please complete the following information.

School/Org Name

Phone

Fax

Address

Address Line 1

Address Line 2

City

State

Zip Code

Email (School)

Email 2

Nominating Teacher Information

Name (Nominating Teacher)

First

Last

Position

Email (Nominating Teacher)

Potential Talent Form (B)

Potential Talent Profile

(to be completed by school or community
organization personnel or private instructor)

Please select a type that most nearly describes you.

The following information is used to determine a student talent profile that will be helpful for MusicLink research and documentation. Complete to the best of your ability, indicating how often the child listed above has shown the following behaviors by selecting the appropriate number.

1 = seldom or never. 2 = occasionally. 3 = frequently. 4 = almost always.

Aptitude and Ability

can remember and repeat melodies and rhythms

keeps a steady pulse and responds to changes in rhythm and tempo of music

can hear small differences in melodies, rhythms and sounds

can differentiate individual sounds in context: identifies patterns, melodies, instruments in a musical composition, or specific environmental sounds

performs with accuracy and ease

Creative Interpretation

enjoys experimenting with sounds: making up songs and manipulating melodies and rhythms

is aware of slight changes in mood, loudness or softness and sounds of different instruments in music

performs and reacts to music with personal expression: shows a personal involvement with the music

Commitment

shows perseverance in musical activities: works with focused concentration, energy and internal motivation

strives to refine musical ideas: sets high goals, constructively critiques musical work of others and self

Please provide further comments describing specific strengths or weaknesses of this child that would be helpful for this profile.

Today's Date

© 1995, 2001, 2005 Joanne Haroutounian.
Permission is granted to reproduce this rating scale for the sole
use of identification of students for the MusicLink program.