The 2005 Heida Hermanns International String Competition

APPLICATION FORM
Must be received by September 21, 2005

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. _________________________________ Instrument: Violin - Viola - Cello - Bass

2. Birth Date: (mo)_____ /(day)_____ / (yr)______ 3. Age as of November 19, 2005: _________

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. Will you need an accompanist? (if yes, please refer to instructions) Yes____ No____

13. How did you hear about The 2005 Heida Hermanns International String Competition?
(please select all that apply) Posting at school____ Internet____ My music teacher____

Other (please explain) __________________________________________________________

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The 2005 Heida Hermanns International String Competition Application Form, Part 2

PLEASE LIST YOUR COMPETITION REPERTOIRE

For Your Three Audition Recordings: Refer to instructions regarding providing and labeling tapes or CDs.

Composer-----------------Full Title-------------------------Movements-------------------------Timing
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For the Semi-Finals: Please list repertoire from which the judges may choose, should you advance to the Semi-Finals.

Composer------------------Full Title-------------------------Movements------------------------Timing
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For the Finals Concert: If you advance to the Finals Concert, the Artistic Director will work with you to select from your Semi-Finals repertoire for the Finals Concert.

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.

Signature: _____________________________________________ Date: ___________________