June 17-21; 9am-1pm
The Music Academy, Loreen Hall
Strings, Piano, Woodwinds

Name (Guardian)

First Name

Last Name

Name (Student)

First Name

Last Name

Name (Student 2)

First Name

Last Name

Name (Student 3)

First Name

Last Name

Name (Student 4)

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

Instrument

Level/Years Played

Piece Last Performed

What grade will you be in fall of 2024?

Group Placement Requests

Write the names of the people you wish to be in a group with (if you know - if not we'll place you).