School of Music

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Full Name*

Age*Age at time of submitting application.

Grade

Grade 9 / FreshmanGrade 10 / SophomoreGrade 11 / JuniorGrade 12 / Senior

Grade currently enrolled in high school.

Street Address*Valid current street address.

City*

State*

Zip Code*

Home Phone*Home phone or parents cell phone number if there is no land line.

Email*Valid home email address, either personal or parents.

Piano teacher's name*

Piano teacher's email address*

Required Repertoire & Performance . At least two works of contrasting style from the standard piano repertoire; Popular music selections are not appropriate. The performance must not exceed 20 minutes. Memorization is required.

Please list your two works below. Include opus number, key and movement.

Title 1*

Composer*

Timing*

Title 2*

Composer 2*

Timing 2*

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