Midwest School of Music Winter Recital

Saturday, March 4 at Piano Solutions
(located at 575 West Carmel Drive, Carmel, IN 46032)

Registration begins: January 1

Application deadline: February 15 (no exceptions)

Non-refundable recital fee: $15 per student

The performance schedule will be posted on schoolofmusic.com beginning Feb 16. Your instructor will also have the students' performance times.

Please complete all required fields on the form below. If any are missing, the form will not submit. The recital fee will be included on your next statement. We cannot guarantee a specific recital time. Please take this into consideration before submitting your application and non-refundable fee.

Contact Information:

Parent(s) name: *

Street address: *

City: *

State: *

Zip code: *

Home phone: *

Cell phone:

E-Mail address: *

Total performers in your family (exclude family members who are providing accompaniment): *

Performers:

1st Performer Information (required):

1st performer's name as it should appear on the program: *

Instrument: *

Please note: if you are performing on anything other than the piano, you will be required to bring your own instrument

Length of study with current instructor: *

Length of study with previous instructor(s): *

Current instructor's name: *

Level (please ask your teacher for this information): *

Composition(s) in the order they will be played (include opus #, movement, etc. if applicable)

1st piece: *

Composer:

Date of birth:

Date of death:

2nd piece:

Composer:

Date of birth:

Date of death:

2nd Performer Information (optional):

2nd performer's name as it should appear on the program:

Instrument:

Please note: if you are performing on anything other than the piano, you will be required to bring your own instrument

Length of study with current instructor:

Length of study with previous instructor(s):

Current instructor's name:

Level (please ask your teacher for this information):

Composition(s) in the order they will be played (include opus #, movement, etc. if applicable)

1st piece:

Composer:

Date of birth:

Date of death:

2nd piece:

Composer:

Date of birth:

Date of death:

3rd Performer Information (optional):

3rd performer's name as it should appear on the program:

Instrument:

Please note: if you are performing on anything other than the piano, you will be required to bring your own instrument

Length of study with current instructor:

Length of study with previous instructor(s):

Current instructor's name:

Level (please ask your teacher for this information):

Composition(s) in the order they will be played (include opus #, movement, etc. if applicable)

1st piece:

Composer:

Date of birth:

Date of death:

2nd piece:

Composer:

Date of birth:

Date of death:

Additional Information:

Preferred time:

Times will be assigned as applications are received and cannot be guaranteed. Please check the performance schedule beginning February 16.

Comments:

Security Challenge: *

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Midwest School of Music Winter Recital

1st Performer Information (required):

2nd Performer Information (optional):

3rd Performer Information (optional):

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