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Faculty Name First*

Faculty Name Last*

Email*

Date of Outreach*

Visit Location

Off Campus (SOM faculty visited the school)

On Campus (A school or group visited RESSOM)

School Name*

Ensemble/class*

Teacher Name*

Type of Outreach (check all that apply)

Sectionals (individual instrument)

Ensemble Rehearsal

Masterclass (individual instrument)

Post-Secondary Audition Preparation

Sectionals (heterogeneous group)

All West/All State Preparation

Masterclass (heterogeneous group

Other (describe below)

Describe Other Type of Outreach

Scheidt Partnership Program

Satisfies the Scheidt Partnership Promise

Number of Students

Grade Range of Students

Hours of Student Contact During Visit

Have you notified SOM Admissions/Recruitment for support and/or follow-up

Yes

No

Notes and Comments

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