ENTRY FORM

Please refer to syllabus for rules of entry and fees Name:

School:

Address:

Class / Year:

Date of Birth:

Home Tel No:

E-Mail Address:

Mobile Tel No:

I consent for my child to be photographed participating in this event Yes / No Signature..................................................................................................... Complete on separate page if necessary

Competition

Number

Duet or Group (Y/N)

Name of Own choice / Conversation topic / Other *Please refer to syllabus for guidance on music submission

Tune names are not required for piping competitions

Copies Enclosed

(Y/N)

Fee

Total Payment Enclosed …………………….

*** Cheques should be made payable to An Comunn Gaidhealach (Meur Dhùn Èideann) ***

For Group entries or duets please list the additional members

Name School Class Date of Birth

PLEASE SEND THIS COMPLETED FORM & APPROPRIATE FEES TO:

Carrie-Anne Gibb Email Enquiries to: 3 Eyre Crescent localmodedinburgh@gmail.com

Edinburgh Download Syllabus at: EH3 5ET www.edinburghlocalmod.com

All entries must be received by 21st April 2017 (*Film entries by 28th April 2017)

LATE ENTRIES CAN NOT BE ACCEPTED

Bun-sgoil Taobh na Pàirce & Pilrig Park School 12th and 13th May 2017