PWS Personnel

Robert Simon, Artistic Director

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PLEASE PRINT THIS FORM BY HIGHLIGHTING FROM THE TITLE TO THE END, THEN CHOOSING PRINT SELECTION FROM THE FILE MENU
DO NOT FILL OUT ONLINE

Deadline for application is Saturday, January 24th, 2009.  

CONCERTO COMPETITION APPLICATION FORM

Must be signed by Parent or Guardian

STUDENT NAME

 

Date

 

Address

 

Birthdate

 

 

 

County of Residence

 

City

 

State

 

Zip

 

Phone
(area code)

 

e-mail:

 

Father’s Name

 

Phone (home)
(area code)

 

Address

 

Phone (work)
(area code)

 

 

 

 

City

 

State

 

Zip

 

Mother’s Name

 

Phone (home)
(area code)

 

Address

 

Phone (work)
(area code)

 

 

 

 

City

 

State

 

Zip

 

 

INSTRUMENT for competition

 

 

SCHOOL INFORMATION

School

Current grade point average  ____ Please circle grade level:   10     11     12   

Current instrument teacher(s)

Band Director Name

Phone (work)

Phone (home)

How long have you studied with this teacher?

Private Teacher Name
Phone (work) Phone (home)

How long have you studied with this teacher?

How long have you been studying music? 

How long have you studied this instrument? 

 

List 3 pieces you have studied recently:

Composition Name

Composer

1.        

 

2.        

 

3.        

 

 List awards, achievements you have received, particularly in music:

Description

Year Received

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 List all past musical studies (other instruments, music courses, etc.)

Description

School

Year(s) Studied

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 What are your plans for future music study, including college?

 

 

 

 

 

By signing this form, I signify that the information on this application is correct.

Student’s Signature

                                                               

Signature of Parent or Guardian

                                                                  

Date

                                                    

Date