2026 Commitment Form Please fill out this form by August 1. "*" indicates required fields InstagramThis field is for validation purposes and should be left unchanged.Personal InfoName* First Middle Last Suffix Preferred First Nameor nickname, if different from above.ECU Banner ID Number*Example: B0123456789ECU Email Address*Use ONLY your email address ending with @students.ecu.edu. Account Information Enter Email Confirm Email Birthdate*MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Age*at the beginning of band camp.Home/Permanent Phone Number*Student's Cell Phone Number*Parent/Guardian Email* Home/Permanent Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Will you live on or off campus during the fall semester?* On Campus Off Campus Medical HistoryPlease list pertinent medical history or conditions that may be relevant to your participation/performance in the Marching Pirates.Allergies/Dietary NeedsCheck all that apply Bee stings Seasonal allergies Vegetarian Vegan Peanut Allergy Tree nuts allergy Soy allergy Fish allergy Shellfish allergy Wheat allergy Grape allergy Watermelon allergy Pineapple allergy Chocolate allergy Blueberry allergy Sesame allergy Lactose Intolerance Gluten intolerance Diabetic Kosher Are you a vegetarian or vegan?* No Yes, Vegetarian Yes, Vegan Current Medications*Please list dosage and frequency.Emergency ContactEmergency Contact Name* First Last Relationship*Emergency Contact Phone Number*Alternate Phone Number*Insurance InformationCompany Name*Policy Number*Other InfoWhat will your academic designation be the start of the fall 2025 semester?* Freshman Sophomore Junior Senior Super Senior Will this be your first year in the Marching Pirates?* Yes No Graduated/Transferred From What School?*Please list even if returningFormer Band Director's Name*How many years have you been a member? (Including the upcoming 2025 season)* 2 3 4 5 Intended Major*What is your current GPA?*List any clubs of which you are a part.*including fraternities, sororities, religious/spiritual clubs, academic clubs, cultural clubs, etc.Why do you want to be part of the Marching Pirates?*Check all that apply. I wanted to continue my music/marching at college. Previous family members in band. Scholarship/stipend opportunity Friendships High Profile Performance Opportunities Something New Become Involved on Campus Other If other, please explain.*Instrument/Performance Area* Piccolo Clarinet Alto Saxophone Tenor Saxophone Trumpet Mellophone Trombone Baritone Sousaphone Drumline Colorguard Dance Team Feature Twirler Drum Major Synthesizer Do you own your own marching instrument?* Yes No NA (for guard, dance, drumline, drum major, twirler, piccolo, mellophone, baritone, sousaphone) Additional Comments/QuestionsAgreementPolicy AgreementBy completing and submitting this form, I: Agree to being a member of the 2025 ECU Marching Pirates and participate in all events outlined in the Practice/Performance calendar, including the entirety of the Preseason Band Camp, all course meeting dates (M/W/F, 4:10-6 p.m.), all scheduled football games and postseason games (when applicable), all scheduled off-campus non-athletic events, etc.; Agree to be assessed in the areas of attendance at all events outlined above, and memorization of all music and visual responsibilities; Agree that in the event that I am rendered unable to communicate due to illness, accident or emergency while participating in activities of the ECU Marching Pirates, I hereby give permission to a Physician selected by the ECU Marching Pirates staff to hospitalize, secure proper treatment for and to take whatever medical actions are necessary to treat me. I further authorize payment for treatment either by me personally or through my medical health insurance provider. Agree that I have read, understand and will abide by the expectations, policies and guidelines for all members of the ECU Marching Pirates for the 2025-2026 academic year. If my plans change, I agree to contact Dr. Busuito as soon as I am aware I agree. Δ
