Student Name *
Student Name
Student Birthdate *
Student Birthdate
Student Address *
Student Address
Student Phone *
Student Phone
Please only fill out if you own or have access to an auxiliary instrument.
Is student currently taking private lessons? *
Lesson Teacher Name
Lesson Teacher Name
Which two (2) supplementary classes interest you the most? *
Parent Name *
Parent Name
Parent Phone *
Parent Phone
Emergency Contact *
Emergency Contact
Emergency Contact Phone *
Emergency Contact Phone
Emergency Contact 2 *
Emergency Contact 2
Emergency Contact 2 Phone *
Emergency Contact 2 Phone
Would you like to apply for a scholarship? *
If you are applying for a scholarship, please share your personal statement of why you are applying and what a scholarship to camp will do for your musical future.
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quINTENS!VE Chamber Music Camp Partners