YOUNG ARTIST COMPETITION 2011 Application Form – Deadline: March 1, 2011 NAME: __________________________________________ DATE OF BIRTH:____________ ADDRESS:__________________________________________________________________ EMAIL: __________________________________________ PHONE:___________________ INSTRUMENT: ______________________________________________________________ SCHOOL CURRENTLY ATTENDING: _____________________________________________ MUSIC TEACHER(S): __________________________ REPERTOIRE SUBMITTED: ______________________________________________________ ___________________________________________________________________________ DURATION (max 20 minutes): ___________________________________________________ PROPOSED SOLO WORK(S) if you win the competition: _______________________________ DURATION (max 15 minutes): ___________________ PAYMENT METHOD: VISA Card Number: _________________________ Expiry Date: ___________________________
SIGNATURE:_______________________________________
DATE:________________
*NOTE: application form must be accompanied by a $30.00 non refundable entry fee payable to the Lethbridge Symphony Association. Payment may be made in Symphony office by cash, cheque, debit or credit card. Deadline: March 1, 2011