The Sherer International Violin & Piano Competition Registration

Personal Information

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone*

Cell Phone

Email

Date of Birth

Parent/Guardian #1 Name*

First Last

Parent/Guardian #1 Email*

Parent/Guardian #2 Name

First Last

Parent/Guardian #2 Email

Parent/Guardian Phone*

Video Recoding Link

Academic Information

High School Name

School Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Current Grade

Please enter a number from 0 to 20.

Personal Instructor Information

Instructor's Name

First Last

Instructor's Email

Instructor's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Instructor's Phone

Years of study with instructor

Please enter a number from 1 to 30.

How did you hear about the Competition?

Please enter a one-paragraph performer biography.*

Musical Composition

List Solo Work- list each work separately (At least 3)*

Composer	Title	Opus, K., BWV, etc.	Key	Movement No. and Title

Additional Information

Do you require an accompanist?

Yes
No

Product Name

Accompanist Fee

Price: $120.00

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Total

$0.00

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