APPLICATION FORM

FOR MADNESS PROGRAM 2006-2007 SEASON

PLEASE CHECK:

  We understand that credit is not provided for missed workshops

  We have read and shared with the student the philosophy statement. 

Click here to learn about The Madness Philosophy.

Click here to learn about Madness Information

 

Student name(s): ____________________________________        

Instrument (s)_________________________________________

Age:  _____        Date of birth:  ___________ _____       

Address:  __________________________________________ __________________________________________

Phone number: (____) _____  ________                

E-mail address(es) ____________________________________________

                           ____________________________________________

(Please include all relevant email addresses for your family)

(We greatly value this mode of communication as a great way to keep in touch with our students.  However, we must be realistic…Please only list an email address if you use it at least once per week!)

STUDENTS: please share your experience level:

What are your latest solo pieces?
Etudes?

Other ensemble experience, latest ensemble repertoire?
Please assess your own sight-reading level.  
School name/home-school? ____________

Do you have an ensemble at your school?  _________
Please describe._________________________

How many year of private study? ____

Private teacher information:

Teacher's Name:                                 Phone number:                              
Mailing address:                                              
E-mail address:                                              

Parents:

Parent/Guardian: Name                                                                   Profession                                              

Employer                                                         
Employer matching program for contributions?                      

 

Parent/Guardian: Name                                                                   Profession                                              

Employer                                                         
Employer  matching program for contributions?                     

It is only necessary to pay for one semester at a time.

 

Application fee: $30      ___

Tuition: $      ____

Please consider adding a donation to Chamber Music Madness, if you haven't recently done so! Your support is vitally important to our efforts. It is fine to include the donation and tuition into one check; we'll send you a separate confirmation for your tax-deductible donation as well as registration.

Also, please click to see our donation form if you'd like to include that with your materials.

Yes, We'd like to add a tax-deductible donation to Chamber Music Madness $ _____
(Thank you so much!)

Grand total: $______________

We understand that credit is not provided for missed workshops          

We've read the Philosophy Statement          

We'd like to bring refreshments on the following date:                    

Also please including the following:

Parent Survey      Volunteer Checklist    This application form 

Please make checks payable to Chamber Music Madness and mail to:

Chamber Music Madness
10734  38th Ave NE
Seattle, WA  98125