The 2014-2015 Justine LeBaron Young Artists Competition

Application Form
Must be postmarked by January 10, 2015, N.B. now extended to January 12
Your complete name _______________________________________ Your age_______
What instrument will you play at the Competition? _____________________________
What is the title of the piece you will play? ______________________________________
What the composers name and birth and death years? ____________________________
Your address_____________________________________________________________
City, State, Zip ____________________________________________________________
Your phone number, including area code _______________________eMail: ___________
Parent(s) name(s) *________________________________________________________
Parent(s) current address * __________________________________________________
Parents phone number(s) * _______________________________eMail: ____________
Name of your school______________________________________________________
Name of your private music teacher(s)________________________________________
Your musical performing experience, please include details, on a separate sheet of paper
Your other activities/interests/honors/awards, etc, on a different separate sheet of paper
I have read, understand and agree to abide by the Competition rules
Your signature _________________________________ Todays Date_______________
Your parents signature * _______________________________________________
Your preferred audition time: __ early morning;

__ mid-morning;

__ late morning

Please print this page and fill out completely. Mail application form, along with the
non-refundable $35.00 application fee. $25.00 for early applications (by December 23).
Make check or money order payable to: Florida Orchestra Musicians Association.
No cash please. Envelope must be postmarked by deadline date. Mail to;
Florida Orchestra Musicians Association Education Committee
c/o William Mickelsen
P.O. Box 541, Palm Harbor FL 34682

* Note; Parental information and signature required only if applicant is under 18