2006 GHLBC Recommendation Form

This form must be postmarked or faxed by January 10, 2006.
Please print-out this form, there are currently no on-line submissions accepted.

Please print carefully and then fax or mail to: 229-333-5807 or 229-259-5578



Name: _____________________________________________________________

Circle One:  Freshman    Sophomore    Junior    Senior

Address: __________________________________________________________

City: __________________________  State: ________  Zip: ___________

Phone: _________________________  Parent's Name: __________________



Circle your primary instrument below:

      Trombone:   Tenor        Bass

      Euphonium:  Bass Clef    Treble Clef

      Tuba


Band Director's Signature: ________________________________________

School: ___________________________  Daytime Phone: _______________

Address: __________________________________________________________

City: __________________________  State: ________  Zip: ___________

Email: ____________________________________________________________

Return Recommendation Forms to:
Dr. Doug Farwell
Department of Music
Valdosta State University
Valdosta, GA 31698-0115
Phone & Fax: 229-333-5807
email: dfarwell@valdosta.edu