Application Form For FSMTA COMMUNITY SERVICE AWARD FOR TWELFTH GRADERS Applicant’s name: ________________________________________________________________

Letter of Recommendation from School Official or Music Teacher

TO: Music-Band-Orchestra-Choral Director and Principals or Vice Principals

The student who sent this form to you is applying for the FSMTA Community Service Award for Twelfth Graders. Any 12th grade student who is currently studying with a Florida State Music Teachers Association member teacher is eligible to apply for this award. The award is given in recognition of the student's leadership, achievements, and service to the community and his/her church or synagogue in the field of music. The award covers activities in the 10th, 11th, and 12th grade of High School. A winner is selected in each county, and from these, a state winner is selected. The state winner is presented a plaque and a check for $500.00 at the End of the Year Awards Program at the winner’s high school. The award is based on the student's participation in school musical activities, church or synagogue activities, community service activities, and his/her study with an FSMTA Member teacher. Your signature will serve as an endorsement and recommendation for the above named student. You may write your letter of recommendation on the following page in the text box. Thank you.

Digital Signature: _______________________________________ School: ______________________________________________ Position: _____________________________________________ Date of End of Year Awards’ Program: _____________________ Time: ___________ Location of Program: ____________________________________________________ Date Letter of Recommendation is sent: ____________________________________ IMPORTANT: Deadline for submission of all application materials is December 31st. After completing this form, please save the interactive PDF file to your computer hard drive. Send it to [email protected] as an email attachment. Within 48 hours of submission, you will receive notification from Joanna that your letter of recommendation has been received. If you have not received notification within 48 hours, please contact Joanna Sobkowska at: 850-980-7038.

Letter of Recommendation from School Official or Music Teacher ~ (Please write your letter of recommendation in the box below)