Tri-M Service Form

First Name

Last Name

Please select the school-related music events you were involved with as a volunteer:

List any non-school related music events you worked for this year in the box:
(example: Performed with woodwind quintet at the Shady Acres Nursing Home for 2 hours)
You may list multiple items in this box.

Select the appropriate boxes:

Are you graduating this year? *

		Yes
		No

At any point during high school, were you a Tri-M Officer? *

		Yes, and I am graduating!
		Yes, but I am not graduating!
		No

* = Input is required