Student Referral Form

Do you know a student who would thrive at Interlochen Center for the Arts? Please refer them using the form below. Members from our admission team will contact your referral and mention your name.

Student First Name

Student Last Name

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Phone

Current Grade Level

What's Your Best Estimate?

Desired Interlochen Program(s)

Interlochen Arts Academy

Interlochen Arts Camp

Interlochen Online

Interlochen College of Creative Arts

Desired Arts Area(s)

Creative Writing

Dance

Film & New Media

Interdisciplinary Arts

Music

Theatre

Visual Arts

I don't know

Instrument

(i.e. bassoon, cello, guitar, voice)

Referrer First Name

Referrer Last Name

Referrer Previous Name, if applicable

Referrer Email

Email is for referral confirmation only.

Referrer Address

Referrer Address 2

Referrer City/Town

Referrer State/Province

Referrer ZIP/Postal Code

Referrer Country

Referrer Relationship to Interlochen (check all that apply)

Academy alumni

Camp alumni

Interlochen Online alumni

Interlochen College of Creative Arts alumni

Parent of student (current / former)

Faculty / staff (current / former)

Other

Years Attended

Referrer Relationship to Student

Educator/Teacher

Friend

Relative (non-immediate family only)

Other…

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