Distinguished Artist Competition Registration Form

Student’s Name__________________________Age________

Student’s Name__________________________Age________

Teacher’s Name_____________________________________

Teacher’s Phone # ___________________________________

Teacher’s Email_____________________________________

Repertoire:  composer, title, opus, key, duration in minutes

Baroque_____________________________________________________________

Classical_____________________________________________________________

Romantic/Impressionistic_________________________________________________

Modern______________________________________________________________

Fee:  $45 / student
One check / teacher
Payable to Shore Music Educators Association

Send to: Lisa Perkins
22 Crest Drive
Little Silver NJ 07739