Locker Request Form

Last Name*

First Name*

APSU Email Address*

Cell Phone

I am a *

Music Major

Non major participating in an APSU ensemble

Select the ensemble(s) you perform with.*

Wind Ensemble

Orchestra

Symphonic Band

GOMB

Jazz Band

Jazz Combo

Guitar Ensemble

Chamber/Other Instrumental Ensemble

Choral Ensemble

Select the ensemble(s) you perform with.

What is your primary instrument?*Select only one

List all instruments that you intend to store in your locker. *Only list instruments that you need for APSU ensembles. Plan to use studio lockers for studio instruments.

Duration*

Fall semester only

Spring semester only

Fall and spring semesters

Select only one (lockers are not available for summer)

Confirmation*

I agree

By submitting this form, I confirm that I have read and agree to abide by the policies pertaining to lockers / facilities described by Austin Peay State University and the Department of Music.

APSU Music Department

Locker Request Form