INTERHARMONY INTERNATIONAL MUSIC FESTIVAL - Sulzbach-Rosenberg, 2012 Sulzbach-Rosenberg, Germany, July 31 - August 12, 2012 APPLICATION Please return your completed application form, an audition recording (non-returnable), and a non-refundable fee of $100 USD by February 1, 2012 to: InterHarmony International Music Festival P.O. Box 286252 New York, NY 10128-0005 U.S.A. Credit card/PayPal also accepted at www.interharmony.com FIRST NAME: _________________________________________________________ FAMILY NAME: ________________________________________________________ NAME OF A PARENT: ___________________________________________________ (if under 18 years of age) GENDER: __Male __Female DATE OF BIRTH: ______________________________________________________ (if 21 and under years of age)
AGE RANGE: __18-20 __21-24 __25-29 __30-34 __35-39 __40-44 __45-60 __Over 60 ADDRESS: ____________________________________________________________ CITY: _______________________________________________________________ STATE/ZIP CODE: _____________________________________________________ COUNTRY: ____________________________________________________________ TELEPHONE: __________________________________________________________ STUDENT EMAIL ADDRESS: ______________________________________________ PAYER EMAIL ADDRESS: ________________________________________________ INSTRUMENT: _________________________________________________________ No. OF YEARS PLAYING: _______________________________________________ TEACHERS: ___________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ MAJOR ACCOMPLISHMENTS (if any): _____________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ STUDENT'S SIGNATURE: ________________________________________________ PARENT'S/TEACHER'S SIGNATURE: _______________________________________ (if under 18 years of age) I LEARNED ABOUT THIS FESTIVAL THROUGH: ______________________________ _____________________________________________________________________ 0 By signing this application, students and/or parents agree to the conditions indicated in the application Information. 0 Enclosed is my check for $160 USD, my non-refundable application fee. 0 No, I am not interested in participating at this time, but please keep me informed of future events of this kind. 0 Double room OR 0 Single room (subject to availability) 0 Audition recording is enclosed.