Wufoo

Name * First Last
UNI Student Number *
Maximum Allowed: 6 characters. Currently Used: 0 characters.
Instrument *
Instrument Ownership
UNI e-mail Address
Non-UNI Email (Optional)
UNI ON-CAMPUS Address (2012-2013)
Residence Hall Name & Room number *

*We must have this information in order to grant early move-in to your residence hall for band camp. Please call the Dept. of Residence 319-273-2333 to get your room assignment and then complete this form.
UNI Phone ### - ### - ####
UNI OFF-CAMPUS Address (2012-2013)*

*Please only complete this section if you are living off-campus during the 2012-2013 school year
UNI off-campus street address
City
State
Zip Code
Cell Phone * ### - ### - ####
*Please list again even if same as UNI Phone
Home/Summer Address
Address
City
State
Zip Code
Home Phone ### - ### - ####
Year in PMB *
Have you been assigned a Leadership position this year?* *
Yes No

*You would have been notified by Dr. Galyen individually
PMB Attire
T-shirt* *
Small Medium Large X-Large XX-Large XXX-Large XXXX-Large Already have

*Required for 1st year members
Gloves* *
Small Medium Large X-Large Already have

*Required for 1st year members
PMB Baseball Hat* *
Need one Have one

*Required for 1st year members
Winds & Percussion Shoes*

*Wind & percussion members are required to wear white shoes. You may wear your white high school marching shoes if they are in acceptable condition.
White marching shoes
Size
Color Guard Shoes*

*Color Guard members are required to wear a specific style of black shoes. If you are a new PMB color guard member please include your shoe size so we can order you the correct shoes.
Black Color Guard shoes:
Size
Additional Information or Comments:
High School Attended
High School Band Director's Name
Major or Intended Major
Hometown
Do Not Fill This Out

Wufoo

UNI ON-CAMPUS Address (2012-2013)

UNI OFF-CAMPUS Address (2012-2013)*

Home/Summer Address

PMB Attire

Winds & Percussion Shoes*

Color Guard Shoes*