VENETIA HALL PIANO CONCERTO COMPETITION

Junior Division of OFMC

APPLICATION FORM

Please complete this application and mail to Chairman Janice Dunphy, 150 N. West St., Westerville, Ohio 43081-1452.  Email:  jandunphy@aol.com.  Include the entry fee in a check or money order for $15 payable to OFMC. 
Application must be postmarked no later than April 1, 2010.            
                                                                  

Entrant Name  __________________________________________

 

Home Address ________________________________________________________ 

 

City _______________________________ State          Zip___________  

 

Home Phone (       )                                                            Cellular Phone (____)____________________ 

 

E-mail: ___________________________________        Date of Birth ________________

 

Name of Junior Music Club _______________________________________________  
 

-OR- I am a Junior Special (Individual) member                  (Yes)

      

Name of Concerto                                                                 Movement________________________
  

Composer  _______________________________________

 

Piano Teacher’s Name _____________________________________                                                                                                                                                                                                                              

Address                                                                   City                                     State            Zip______ 
    

Teacher’s Signature___________________________________________________ 

1.  Please attach a brief resume of musical background.  

2.  Enclose $15 entry fee (check or money order made payable to OFMC) with the    

     application form.

3.  Make sure all information is filled in completely.

4.  Sign your application.

 

I certify that I have read the entrance requirements and that I am eligible to enter this competition as a citizen of the
United States.   I promise to comply with all conditions and requirements of the official rules.

 

Signature of Entrant                                                                               Date ________________