Name of Applicant/Student who will perform in this competition *

First Name

Last Name

Applicant's Phone Number *

(###)

###

####

Applicant's Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of Applicant's Parent/Guardian *

First Name

Last Name

Parent/Guardian's Phone Number *

(###)

###

####

Name of Applicant's Music Teacher *

First Name

Last Name

Music Teacher's Phone Number *

(###)

###

####

Name of Accompanist *

Contestant MUST have an accompanist if the music being performed has an accompaniment. Contestants without access to an accompanist can request help from the Thursday Morning Music Club in finding one if a request is made by mid-January.

First Name

Last Name