The 2006 Heida Hermanns International Piano Competition

APPLICATION FORM
Must be received by October 2, 2006

Please refer to the Application Checklist for the full requirements of your Application.

(Please print out and complete by typing or printing clearly)

1. Name: Mr. / Ms. _________________________________

2. Birth Date: (mo)_____ /(day)_____ / (yr)______ 3. Age as of December 2, 2006: _________

4. Social Security No.: ___ ___ ___ - ___ ___ - ___ ___ ___ ___

5. Form of I.D. you are enclosing (copy of): Birth Cert____ Passport____ Driver’s License____

6. Current Address: __________________________________________________________

7. Current Phone: (_____) ________________ 8. Home Phone: (_____) _________________

9. Current Email Address: ______________________________________________________

10. Permanent Address: _______________________________________________________

11. Will you need local accommodations? Yes____ No____

12. How did you hear about The 2006 Heida Hermanns International Piano Competition?
(please select all that apply) Posting at school____ Internet____ My music teacher____

Other (please explain) __________________________________________________________

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The 2006 Heida Hermanns International Piano Competition Application Form, Part 2

PLEASE LIST YOUR COMPETITION REPERTOIRE

For Your Initial Recordings: We require three identical copies. Please DO NOT write your name on the tapes or CDs themselves, but DO print your name and selections on the case or case insert; include titles, keys, movements, opus numbers, etc. Refer to instructions for complete information.

Composer-----------------Full Title-------------------------Movements-------------------------Timing
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For the Semi-Finals

Composer------------------Full Title-------------------------Movements------------------------Timing
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For the Finals Concert: After your Semi-Finals audition, you will be asked to submit repertoire for the Finals Concert from your Semi-Finals repertoire, in case you advance to the Finals Concert. See instructions for more information.

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I certify that all information given above is correct to the best of my knowledge. I agree that the decisions of the judges shall be final, that I will make no claims of any kind against the Competition or Connecticut Alliance for Music, Inc., and that I shall assent to and comply with all rules and regulations of the Competition. I understand that the Finals Concert will be recorded and the recordings used by Connecticut Alliance for Music, Inc., for promotional purposes. If I advance to the Finals Concert, I give permission for my performance to be recorded for this use and for my name and biography to be posted on the Connecticut Alliance for Music website. I have made a copy of this application for my own reference.


Signature: _____________________________________________ Date: ___________________