20th/21st Century Music Festival Online Application

First Name

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Last Name

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Email

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Student First Name

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Student Last Name

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Student First Name

(Second Performer, if duet)

This field is required.

Student Last Name

(Second Performer, if duet)

This field is required.

Student's Age

This field is required.

Parent's First Name

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Parent's Last Name

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Parent Phone Number

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Parent Email

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Number of Pieces

1

2

3

This field is required.

Composition (1)

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Composer (1)

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Composer Date (1)

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Timing (1)

In Minutes

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Composition (2)

This field is required.

Composer (2)

This field is required.

Composer Date (2)

This field is required.

Timing (2)

In Minutes

Composition (3)

This field is required.

Composer (3)

This field is required.

Composer Date (3)

This field is required.

Timing (3)

In Minutes

Is the student playing the commissioned work Night Thoughts by Emily Martin?

Yes

No

This field is required.

Total Timing

Application Fee: $50

Please Note:
The application fee is non-refundable after the application due date.

*A non-refundable processing fee of 2.2%+$0.30 will be added to the final amount*

$51.40

PayPal

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20th/21st CENTURY PIANO FESTIVAL APPLICATION

Teacher's Information

Student/Parent Information

Program