Talent Search Application

Parent / Guardian Information
Parent/Guardian 1 Name*

First nameLast name
Parent or Guardian 1 Name*
Relationship to Student*
Address*

Street Address

Apartment, Suite, etc.

CityState

Zip Code
Address*
City, State*
Zip Code*
Cell Phone*
Please enter a valid phone number.
Cell Phone (include area code)*
Text Message Opt-in*

Yes, I want to receive program information through text messages.No, I do not want to receive program information text messages.
Email address*
example@example.com
Talent Search respects your privacy. Your phone number and email will be kept confidential and will not be shared or distributed to any third parties.
Parent/Guardian 2 Name

First nameLast name
Parent or Guardian 2 Name
Relationship to student
Address

Street Address

Apartment, Suite, etc.

CityState

Zip Code
Address
City, State
Zip code
Cell Phone
Please enter a valid phone number.
Cell Phone (include area code)
Text Message Opt-in

Yes, I want to receive program information through text messages.No, I do not want to receive program information text messages.
Email address
example@example.com
Talent Search respects your privacy. Your phone number and email will be kept confidential and will not be shared or distributed to any third parties.

AUTHORIZATIONS AND SIGNATURES:
AUTHORIZATION TO OBTAIN AND UTILIZE IMAGES –By signing below, the parent/guardian of the student applicant hereby grants permission to MSU Talent Search to photograph and/or videotape either the adult parent/guardian or the minor child upon admission into MSU TS. The parent/guardian also authorizes MSU TS to use and/or permit others to use the aforementioned images in educational, informational, and promotional activities for MSU TS without compensation.

AUTHORIZATION TO RELEASE ACADEMIC / EDUCATIONAL INFORMATION – The parent/guardian authorizes the student’s schools to release any academic/educational information from the student’s files that are requested by MSU TS and authorizes MSU TS to release academic/educational information to assist in the student’s education.

I agree to the above statements and verify that by signing this document and submitting the requested documentation that the income and personal information which I have provided is accurate to the best of my knowledge. I understand that the information will be held in complete confidence by the Talent Search program at Murray State University.
Student Signature:*

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Date:*

MonthDayYear
Today's Date
Parent/Guardian Signature:*

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Date:*

MonthDayYear
Today's Date
Should be Empty:

Talent Search, Murray State University