Practice Room/Keycard Request Form Please complete this form for Practice Room access. Personal InformationName* First Last CSU ID (numbers only, 9 digits)*Email* Enter Email Confirm Email What is your primary instrument?* Bassoon Clarinet Cello Double Bass Euphonium/Baritone Flute Guitar Harp Horn Oboe Organ Percussion Piano Saxophone Trombone Trumpet Tuba Violin Viola Voice (including musical theatre) I am a non-performing arts major enrolled in a CSU large ensemble this semester (i.e., band, orchestra, choir, jazz ensemble)* Yes No What ensemble are you a member of?* Wind Symphony Symphonic Band Concert Band Marching Band University Symphony Orchestra Concert Orchestra Jazz Ensemble Jazz Combo Chamber Choir Concert Choir University Chorus Opera Production Percussion Ensemble I am a non-performing arts major enrolled in applied lessons this semester* Yes No I am a non-performing arts major in the Musical Theater production this semester* Yes No Practice Room/Keycard Access RequestBy clicking yes, I understand that my practice room/keycard access will begin when I receive email confirmation from the department.* Yes No Do any of these conditions apply to your circumstances? Choose from the following:* I am enrolled as a music minor, but will not be taking lessons this semester None of these conditions apply to me Terms and ConditionsOnly students enrolled as music majors, music minors enrolled in applied lessons for the current semester, or musical theatre concentration majors will receive access to the practice rooms included with the Music Program Fee. Any other student requesting access for the semester will have their student account billed $50 for the use of the practice rooms for the semester.*As a student who doesn't meet the above-described criteria, I understand these terms and give permission for my student account to be charged $50. Yes No N/A - I meet the above criteria Liability and Insurance*The Colorado State University School of Music, Theatre, and Dance, and its faculty and staff, are not liable for any lost, stolen, or damaged property left in a practice room. I understand that it is my responsibility to insure my property, and by entering into this practice room/keycard agreement, I release CSU and its employees from all liability. Yes, I understand and agree to these terms. Replacing CSU ID*By submitting this form, I understand that if I lose my CSU ID, which is also my practice room/keycard access, the School of Music, Theatre, and Dance is not responsible for any fees associated with replacing your CSU ID. Yes, I understand and agree to these terms. Contact Gretchin WheelerAdministrative Assistant970-491-3087gretchin.wheeler@colostate.edu