GENERAL INFORMATION
Name:		Age:
Address:
City:		State:
Zip:		County:
Phone:
Parent's Name:		Parent's Email:
Instrument:
School:		Grade:
School Address:
City:		State/Zip:
Hometown Newspaper:
Address:
City:		State/Zip:
COMPOSER, COMPOSITION, AND MOVEMENT (MUST be from the Competition Repertoire List.)
Composer:
Composition:		MVT and Length:
TEACHER CERTIFICATION (May be completed by one or both teachers)
I believe my student:	is capable of fulfilling all the requirements of the above competition. has consulted the rules, and has selected a piece from the official Repertoire List
PRIVATE TEACHER INFORMATION:
Private Teacher:
Address:
City:		State/Zip:
Phone:		Email:
Private Teacher Signature:		Date:
SCHOOL MUSIC TEACHER INFORMATION:
School Music Teacher:
Address:
City:		State/Zip:
Phone:		Email:
School Music Teacher Signature:		Date:
THE FOLLOWING MUST BE RECEIVED OR POSTMARKED BY JANUARY 4, 2009:
a. THIS COMPLETED APPLICATION/TEACHER CERTIFICATION FORM b. Non-refundable application fee of $30 made payable to The Orchestra of Northern New York Competition. Mail this completed application form and entry fee to: The Orchestra of Northern New York Attn: Young Artists Competition P.O. Box 488 Potsdam, NY 13676