BCPS Interest Form

Student Information

Please complete the following student biographical information:

Did you participate in this program last year?*

Yes
No

Student's full name*

First Last

Student's date of birth*

Student's address*

Street Address City State ZIP Code

Parent/Guardian's full name*

First Last

Parent/Guardian's primary phone*

Parent/Guardian's primary email*

All communication regarding this application will be sent to this email address.

Enter Email Confirm Email

Student's school in September of the upcoming school year*

Select First Instrument Choice*

Flute
Low Brass
Percussion
Trumpet

Select Second Instrument Choice*

Flute
Low Brass
Percussion
Trumpet

Select Third Instrument Choice*

Flute
Low Brass
Percussion
Trumpet

Select Instrument Choice*

Violin (Thursday class)

Select First Instrument Choice*

Clarinet (Friday class)
Flute (Friday class)
Guitar (Monday class)
Guitar (Tuesday class)
Low Brass (Thursday class)
Percussion (Thursday class)
Trumpet (Monday class)

Select Second Instrument Choice*

Clarinet (Friday class)
Flute (Friday class)
Guitar (Monday class)
Guitar (Tuesday class)
Low Brass (Thursday class)
Percussion (Thursday class)
Trumpet (Monday class)

Select Third Instrument Choice*

Clarinet (Friday class)
Flute (Friday class)
Guitar (Monday class)
Guitar (Tuesday class)
Low Brass (Thursday class)
Percussion (Thursday class)
Trumpet (Monday class)

Student's grade in September of the upcoming school year*

Demographic Information

The following questions are included for statistical purposes only.

Gender Identity*

Please self-describe below*

Is the student of Hispanic, Latino, or of Spanish origin?*

Yes
No
Prefer not to answer

How would you describe the student?*

American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other
Prefer not to answer

Checking the box below indicates your acknowledgment and agreement to the above and all applicable Peabody and University policies and procedures as outlined in our catalogs and on our websites. Your registration cannot be processed without agreeing to these terms.*

I have enrolled myself and/or my child(ren) in one or more programs, classes, lessons and/or other activities of the Peabody Preparatory of the Johns Hopkins University (collectively, the “program”).

I understand that participation in the program may require extensive and rigorous physical exertion and activity, and that there are a wide variety of risks that could result in serious injury or death. I further understand that there are some disciplines wherein the teaching process requires an instructor to illustrate proper techniques or positioning by touching a student. Parents/legal guardians of minor students and adult students who may have concerns about this issue should speak with their instructor or the head or director of the program about this issue prior to enrollment in the program and the commencement of instruction.

I represent that I and my child(ren), if enrolled in a program, are covered throughout the program by a policy of comprehensive health and accident insurance, which provides coverage for illnesses or injuries that may be sustained as a result of my or my child(ren)’s participation in the program.

Photo Release. The Peabody Preparatory of The Johns Hopkins University reserves the right to take photographs or video of faculty, staff, and students, engaged in teaching, rehearsals, and performances and other activities at the Preparatory for use in promotional purposes and may be used in future print and electronic publications and media communications. Classes and individual instruction will only be photographed with the permission of the faculty member; performances and rehearsals will only be photographed with the permission of the conductor or director in charge of the event. Such photographs will be retained in the Peabody files and archives and may be used by Peabody without limitations or restrictions as to time. Peabody has no control over the use of photographs or film taken by the news media covering Peabody events.

The University prohibits discrimination and harassment, including sexual misconduct and sexual harassment and requires the prompt reporting of any suspected child abuse. Relevant University policies include JHU’s Policy on the Safety of Children in University Programs, JHU’s Anti-Harassment Policy, and JHU’s Sexual Misconduct Policy and Procedures, available at: https://peabody.jhu.edu/preparatory/registration-financial-aid/policies/.

If you are an eligible Johns Hopkins University employee or retiree and plan on using the Tuition Remission Plan through Johns Hopkins University for yourself or family members the following statement applies to you:

ELIGIBILITY: Full-time Johns Hopkins University faculty and staff, and their spouses and dependent children qualify for Tuition Remission after the employee completes 120 days of full-time employment at the university.

Domestic partners and their dependent children may also participate in the Plan. However, any benefit provided for an employee’s domestic partner or their dependent children will be taxed. The university will withhold these taxes from the employee’s paycheck. Retirees, their spouses and dependent children are also eligible for Tuition Remission for Johns Hopkins courses.

To be considered a “dependent child”, the child must:

1) be a US citizen, resident alien or a resident of Canada or Mexico;

2) not file a joint return if married unless the return is filed only to claim a refund of tax when neither spouse is required to file, and no tax liability would exist for either spouse if separate returns were files;

3) be a blood descendent of the first degree, legally adopted or a stepchild;

4) have the same principal residence as the employee for more than half the year excluding temporary absences such as residing on campus (special rules may apply to children of divorced or separated parents);

5) be under 19 years old or, if between the ages of 19 and 23, be a full-time student; and

6) not provide over one-half of his or her own support for the calendar year.

I approve the use of Tuition Remission and agree to pay the value of studies taken beyond the dollar limits provided by this benefit.

Agree

Comments

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