AMTA Piano Festival - Student Registration Form

Please photocopy this form as needed to create a separate registration form for each student.

Student Name: ___________________________________________________________________

Please clearly print name exactly as you would like it to appear on the certificate.

Age: _________ Grade: ________ Years Studied: _________ Teacher: ____________________ Parent phone: _________________________ Parent email: _______________________________ Siblings participating: _____________________________________________________________ Performance Level (Teacher discretion) Early Elem. Elem. Late Elem. ______ ______ ______ Early Inter. ______ Early Advanced ______ Advanced ______

Intermediate ______ Late Inter. ______

Skills Challenges (Please check the challenges in which the student will participate and indicate the level.) Sight Reading Participating ______ Level _______ Scales / Cadences Ear Training Theory Test Hymn Playing Duet Participating ______ Participating ______ Participating ______ Participating ______ Participating ______ Please fill out and submit the Duet Registration Form Level _______ Level _______ Level _______

Please mail Registration forms and cover sheet by postmark deadline February 20, 2013 (or hand deliver by February 21) to Laura Lowe 1356 Montrose Place Evans, GA 30809 706-868-1126 lylowe@gmail.com