Upload
others
View
0
Download
0
Embed Size (px)
Citation preview
BSS Summer Workshop August 12 - 16, 2019 Chamber Music Program
Fill out the form below and return it with the student information form and full payment to:
Buffalo Suzuki Strings, 4 Webster St., N. Tonawanda, NY 14120
Deadline for registration: May 17, 2019 Applications received after this date will be accepted based on
availability.
Early registration bonus: Sign up before May 1 and receive a discount!
No refunds after June 15.
A workshop T-shirt is included for everyone: please select a size.
Youth XS S M L Adult S M L XL
Payment (circle): check cash credit card
Amount: $____________ Zip Code: ____________
CC# ___________________________________________
Expiration _______________ Security code ___________
Signature________________________________________
Please fill out this form in its entirety and return it with your full payment. No refunds after June 15.
One student per form.
STUDENT INFORMATION
Name: ______________________________________ Age: ________
Address: _________________________________________________
Parent(s) Names: __________________________________________
Phone: ___________________ E-mail: _________________________
Instrument: ________________ Teacher: _______________________
CHAMBER MUSIC PROGRAM INFORMATION Please complete to ensure proper ensemble placement.
Current working piece: ______________________________________
Composer: _________________________ NYSSMA Level: ________
Violin students: are you willing to play viola?
In orchestra __________ In a chamber ensemble _________
Class Tuition
Discount tuition, prior
to May 1 Amount Paid
Chamber Music Violin - late book 5 and up Advanced viola, cello, & piano $375 $350 $____________