Application Form
Chapter 4242 Advisors: Mr. Coniglio & Mr. Romeo
Name________________________________ Date _____________ Grade_________
E-mail_______________________________ Cell #____________________________
Polo Size_____ Member of: (check all that apply) BAND _____ CHORUS_____
Application Requirements:
• Attach a 2-page essay to this form stating why you think you should be considered as a candidate for Tri-M
Music Honor Society. Please include how the three M’s (Modern, Music, Masters) of Tri-M are related to your
candidacy. (This only has to be completed as part of the initial application)
• Must be currently enrolled in a music class(es) or ensemble(s) while having a 90 average or better.
• Must have a GPA of 85 or better.
• Must demonstrate a high level of musicianship by having performed an approved vocal or instrumental solo,
duet, or small chamber ensemble piece at a sanctioned NYSSMA Adjudication Festival at a minimum
NYSSMA Level III (receiving an Excellent or higher) yearly. Attach a copy of your NYSSMA Adjudication
sheet from the most recent school year.
• Read and understand the “Information and Expectations” page.
Signature of Applicant____________________________________
Signature of Parent/Guardian_________________________________
This form is due April 1st
