Music Proficiency Last Name(required) First Name(required) Email(required) Age(required) Gender(required) Select Male Female List your current occupation (e.g., researcher) or level of education (e.g., undergrad, graduate)(required) and year in school (e.g., first, second, ABD; if applicable)(required) As far as you know, do you have normal hearing?(required) Select Yes No 1B. To the best of your knowledge, did you ever have a middle ear infection as a child or any other disease that might have affected your hearing? If so, please state when the afflictions occurred.(required) Select Yes No Have you ever had any music lessons (e.g., private or group music lessons)?(required) Select Yes No 2b. If you have taken music lessons, please state the type of lessons you had, the instrument(s), and the year(s) you were enrolled in the lessons. Please be as specific as possible. 2c. If you have taken music lessons, please list again the instrument(s) you studied and your proficiency on a scale from 1 (not proficient) to 10 (extremely proficient/professional). Please also list the number of hours, on average, you play the instrument each week in the past 24 months, and the age at which you started playing the instrument. 2d. If you have taken music lessons, please list the style of music you studied (e.g., jazz piano; classical voice). How many years of training did you complete in that particular style? How much time do you spend thinking about your music (e.g. making musical choices), independently of playing, each time you practice? Answer in minutes or hours.(required) Have you ever participated in a music ensemble (e.g., school choir, local band or professional orchestra)?(required) Select Yes No 4b. If you answered yes to the previous question, please list the instrument you played, the group(s) you participated in, and the year(s) during which you participated in them (e.g., 1995-1996). If you currently play with these groups, please list how many hours a week you play with them. Also include solo work. Be as specific as possible. Can you read music?(required) Select Yes Sort of No 5b. If you answered “yes” or “sort of” to the previous question, please list the type of score (e.g., Western five-line score; Chinese simplified score), clef (e.g., treble clef; alto clef), and level of proficiency on a scale from 1 (not proficient) to 10 (very proficient/professional). Have you ever been a part of a young artist music program, festival, or competition?(required) Select Yes No 6b. If you answered “yes” to the previous question, please specify the instrument you played, the name of the festival, program, or competition, and the years you participated in them. Do you have professional musicians in your family?(required) Select Yes No 7b. If you have professional musicians in your family, please specify the occupations of those family members who are professional musicians. Do you have/are working on a degree in music?(required) Select Yes No 8a. If you answered “yes” to the previous question, please list the title of the degree(s), the institution(s) you studied at, and what year it was/will be awarded Have you ever taught music lessons?(required) Select Yes No 9b. If you answered “yes” to the previous question, please list the instrument you teach/taught, the style you taught, and the years you taught Please state any additional information about your music background. On a daily basis, how many hours do you listen to music?(required) How well do you understand music theory (Western or other)? (rate on a 7 point scale, 1= not at all, 7= completely)(required) Select 1 2 3 4 5 6 7 How often do you listen to music while you work? (rate on a 7 point scale, 1 = never, 7 = all the time)(required) Select 1 2 3 4 5 6 7 How distracting is listening to music while you work? (rate on a 7 point scale, 1 = very distracting, 7 = not distracting at all)(required) Select 1 2 3 4 5 6 7 How often do you listen to music while you drive? (rate on a 7 point scale, 1 = never, 7 = all the time)(required) Select 1 2 3 4 5 6 7 How distracting is listening to music while you drive? (rate on a 7 point scale, 1 = very distracting, 7 = not distracting at all)(required) Select 1 2 3 4 5 6 7 How good is your pitch recognition skills? (rate on a 7 point scale, 1= “I think I’m tone deaf”, 7= “I think I have perfect pitch”)(required) Select 1 2 3 4 5 6 7 What would you define as your level of participation when you hear a new song? Check all appropriate choice(s). I often find myself tapping/moving to the beat I often find myself singing the tune I often find myself imagining that I'm playing the musical piece I often improvise along with the musical piece None of the above Share this:ShareTwitterLinkedInGoogle +1FacebookEmail