APPLICATION FORM

2022

Participant’s Personal Data:

Name: Rasmi Ranjan Sahu Age: 14
Date of Birth*:12 October 2007 Gender: Male
Citizenship/ Permanent Residency*: Indian
(*Photocopy of a valid passport or birth certificate is required)
Email: rasmisahu2007@gmail.com
Address: 888 Lenong St, Francistown
Postal Code:
Mobile Phone: +267 73081354
Do you own a digital piano currently? Yes

What brand of the digital piano, year and model?

Yamaha DGX-660 Portable Grand 2016 model

ATTACHED PHOTO here:

by Unknown
Teacher’s Information:
Current teacher’s Name: ______________________________________
Length of Study in piano: (years)
Current teacher’s Email:
Current teacher’s Phone: +267 77890296

Education:
List the schools you have attended, starting with the most recent:
Clifton College Francistown___________________________________________

Prizes, Scholarships and Awards:

Please list (by year and title) any competition prizes, awards, or scholarships you have won:

ABRSM______________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
___________________________________________________

Band Engagements:
Please list any band with whom you have performed as digital piano soloist:
Repertoire Requirements:

Participants must present 1 selection totaling a maximum playing time of 8 minutes.

• Any performance form is allowed.
• All creative performing arrangement is encouraged. Styles may include solo
performance, singing with self accompaniment, orchestral combo arrangement, and others.

Checklist:
Have you remembered to include:
1) A completed application form with complete and accurate details
2) A photocopy of your passport or birth certificates
3) Application fee is non-refundable. Please make payment to
The Piano Room (Pty) Ltd. (For payment details, please enquire from JD. 77183068.)

Signature of Consent:
I Hereby acknowledge that I have read and agree to abide by the official Rules and Guidelines as
outlined by 2022 Pearl River Digital Piano International Competition Committee. My signature
below indicates full understanding of the conditions of my participation in (and preparation for) the
national auditions, as well as my commitment to uphold the highest of standards when performing
in Guangzhou, China. By participating in 2022 Pearl River Digital Piano International Competition,
I consent to be photographed and to be included in the filming of footage documenting the event
and grant Guangzhou Pearl River Kayserburg Piano Co., Ltd. full and complete permission to
utilize these images or footage. I undertake to honour these rules and also to accept all decisions of
the Jury.

Name and the signature of Applicant / Date:

Name and the signature of Parent or Guardian / Date:

MAIL YOUR COMPLETE: THEPIANOROOMBOTS@GMAIL.COM

APPLICATION TO: THE PIANO ROOM (PTY) LTD

ADDRESS: PLOT 7924 (CHESS SCHOOL) EXTENTION 24 MARUAPULA

GABORONE BOTSWANA

CONTACT: 00267-77183068 or 00267-71321453