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Symposium application form
Symposium application form
Symposium application form
Composers’ Symposium
Application: Submit by May 24, 2024
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Student’s Last Name First Name
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Student’s Email Address Student’s Phone #
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Name of School City
What instruments do you play and how long have you played them?
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___ Band ___ Jazz Band ___ Orchestra ___ Choir ___ Musical Theater
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Teacher’s Name # of Years Studying with this Teacher
• Submit your application to: PO Box 2405, Newport, OR 97365 or email your application
to: dr.michael.dalton@gmail.com
Parent/Guardian Information:
Email: _________________________________________________________________
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Student’s Signature Date
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Parent/Guardian’s Signature Date