2018 American Saxophone Academy Registration Form · PDF file · 2017-12-12Title:...
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2018 American Saxophone Academy Registration Form I. STUDENT INFORMATION ________________________________ Female Male ________________________________ Last Name, First Name Emergency Contact Person/Phone/Relationship __________________________________________________ (______)_________________________ Home Address City/State/Zip Student’s Preferred Phone _____________________________________ ___________ (______)_________________________ E-mail Address (print clearly) Date of Birth Student’s Alternative Phone ________________________________ ________________ (______)_________________________ Summer Address (if different) Effective Dates for Summer Telephone Number (Cell) Summer Address ________________________________ ________________ ________________________________ State of Legal Residence (if you are a U.S. citizen) County Instrument ________________________________ ________________ Are you a permanent resident? Country of Citizenship (if not U.S.) Type of visa/exp. Date YES NO Have you attended the University of Iowa before? YES NO If “Yes,” last date of attendance: ________________ Name of when enrolled: ____________________________________ II. EDUCATIONAL HISTORY Please submit a resume on a separate sheet. III. PERFORMANCE INFORMATION A. Please list in the order of proficiency and preference of saxophone (soprano, alto, tenor or baritone) that you would like to perform in quartet and large ensemble. You will be expected to audition on the instrument of your preference for the quartet assignment. 1._________________________ 2._________________________ 3._________________________ 4._________________________ B. Which saxophone(s) would you be able to bring? 1._________________________ 2._________________________ 3._________________________ 4._________________________
Transcript of 2018 American Saxophone Academy Registration Form · PDF file · 2017-12-12Title:...
2018AmericanSaxophoneAcademyRegistrationFormI.STUDENTINFORMATION________________________________ Female Male ________________________________LastName,FirstName EmergencyContactPerson/Phone/Relationship__________________________________________________ (______)_________________________HomeAddress City/State/Zip Student’sPreferredPhone________________________________________________ (______)_________________________E-mailAddress(printclearly) DateofBirth Student’sAlternativePhone________________________________________________ (______)_________________________SummerAddress(ifdifferent) EffectiveDatesfor SummerTelephoneNumber(Cell)
SummerAddress________________________________________________ ________________________________StateofLegalResidence(ifyouareaU.S.citizen)County Instrument________________________________ ________________ Areyouapermanentresident?CountryofCitizenship(ifnotU.S.) Typeofvisa/exp.Date YES NOHaveyouattendedtheUniversityofIowabefore? YES NOIf“Yes,”lastdateofattendance:________________ Nameofwhenenrolled:____________________________________
II.EDUCATIONALHISTORY Pleasesubmitaresumeonaseparatesheet.III.PERFORMANCEINFORMATION
A. Pleaselistintheorderofproficiencyandpreferenceofsaxophone(soprano,alto,tenororbaritone)thatyouwouldliketoperforminquartetandlargeensemble.Youwillbeexpectedtoauditionontheinstrumentofyourpreferenceforthequartetassignment.1._________________________2._________________________3._________________________4._________________________
B.Whichsaxophone(s)wouldyoubeabletobring?
1._________________________ 2._________________________ 3._________________________4._________________________
______________________________________________________________________________IV.HOUSING/MEALSWORKSHEETWillyouneedhousinginaresidencehall? Yes No Ifso,pleasechooseoneoptionandsendinamountindicatedbelowalongwithyourtuition.*ThereisNOearlyarrival.OptionIJune21st June30th 9X$55/night= $495Check-InDate(Noon) Check-OutDate(byNoon) #ofNights Total(includebelow)OptionIIJune22nd June30th 8X$55/night= $440Check-InDate(Noon) Check-OutDate(byNoon) #ofNights Total(includebelow)Doyouplantoeatmealsinauniversitycafeteriaduringyourstay? Yes No Ifso,pleasenotethatmealscost$28.50perday,andincludebreakfast($7.50),lunch($10.50),anddinner($10.50).Thedininghallsarecashless,soyouwouldneedtopurchasemealsatthecafeteriadoorusingacreditcard–Visa,Mastercard,orDiscover.TherearealsomanyexcellentdiningoptionsthatareoffcampusbutneartheASAsite.
V.REGISTRATIONINFORMATIONASATuition $760.00Housing(fromabove) $_______________
TOTAL $_______________
VI.PAYMENTINFORMATIONIMPORTANT:Dr.KennethTsemustapproveyoutoregisterbeforeyousendthecompletedformandpayment.OnceDr.TsehasapprovedyoutoregisterfortheASA,pleasemailacheckormoneyorderpayabletotheUniversityofIowato:
LisaKrause1400LVOXSchoolofMusicUniversityofIowa93EBurlingtonStIowaCity,IA52242
NOTE:Creditcardscannotbeacceptedatthistime.
VIII.PHOTOGRAPHY,SOUNDANDVIDEORECORDINGRELEASEI,_____________________________________(nameofstudent),herebyconsenttobephotographedandrecorded(soundandvideo)fortheUniversityofIowa.Theresultingphotographs,soundandvideorecordingsmaybesubsequentlyusedwithoutcompensationtomebytheUniversityofIowaorthirdpartiesforpublications(includingwebsites),advertising,and/orpublicitypurposesatthediscretionoftheSchool’sCommunicationsOffice.Iwaivetherighttoinspectorapprovethefinishedphotographand/orrecordingand/orpublicationuse.Thisreleaseformwillbekeptonfile.
____________________________________________________________________________SignatureofStudent(or,ifstudentisunder18yearsofage,signatureofparentorguardian)
