FACULTY Non-Profit Org. US Postage PAID - MSQ-Home · PDF fileworks from the string quartet...

4
Non-Profit Org. US Postage PAID Pittsfield, MA Permit No. 36 e Manhattan String Quartet 115 W. 73rd Street, Suite 7A New York, NY 10023 Return Service Requested June 12-18, 2017 at Colgate University, Hamilton, NY June 19-25, 2017 at Seattle Pacific University, Seattle, WA www.ManhattanStringQuartet.com Bartok: String Quartet No.1,Op. 7 June 12-18, 2017 at Colgate University in Hamilton, NY June 19-25, 2017 at Seattle Pacific University in Seattle, WA STRING QUARTET CONFERENCE KentMusic offers experienced string players the opportunity to spend six gratifying days studying major works from the string quartet repertoire. Participants receive high-level coaching from world-class performing musicians, attend lectures and concerts by the faculty artists, and have ample time for informal quartet readings and socializing. THE MANHATTAN STRING QUARTET

Transcript of FACULTY Non-Profit Org. US Postage PAID - MSQ-Home · PDF fileworks from the string quartet...

DAVID CLAMPITT is a music theorist and violinist who taught at Yale University for 11 years before joining the faculty at Ohio State University, where he is Associate Professor. A founding member of the Algonquin String Quartet during his years as a violinist in New York City, he has been a regular member and occasional soloist with Orchestra of New England in New Haven and has appeared as a recitalist at Yale. He has coached and lectured at KentMusic since 1990 and has also given his popular lecture/demonstrations with the

Manhattan String Quartet in New York City and in Europe.

ADDITIONAL FACULTY (for session at Colgate University) include Michael Emery, violinist (faculty Skidmore College); Austin Hartman, violinist (Biava Quartet); Kaethe Jarke, cellist (Shanghai Quartet); Joel Pichon, violinist (faculty Smith College); and Liuh-Wen Ting, violist (Meridian Quartet).

All KentMusic coaches are highly regarded chamber musicians with extensive performance and coaching experience. Unique to KentMusic, all coaches are current or former members of internationally renowned string quartets.

Hailed by the Boston Globe as “a national treasure,” the MANHATTAN STRING QUARTET is celebrating its 47th season. Well known for performances of 20th-century “classics,” the Manhattan Quartet has established a significant international reputation with regular concert appearances throughout North America, Europe, Latin America and Asia. After a series of concerts in Moscow and Leningrad in the fall of 1985, the Quartet became the first American classical ensemble to give a full tour of the Soviet Union under that era’s new cultural agreement. Their first sold-out series of performances in 1986

was followed by an equally successful tour in 1989. In 2005, the Quartet made its first tour of Asia and played to sold-out houses in Nagoya and Tokyo, Japan. Notable among its many recordings is the complete cycle of 15 Shostakovich string quartets that TIME Magazine called “One of the most important musical events of 1991.”

The group has been Quartet-in-Residence at Colgate University since 1988 and has held similar posts at the Manhattan School of Music, Cornell University, Grinnell College, Connecticut’s Music Mountain Festival and Michigan’s Interlochen National Music Camp (for 22 summers). In 2011, in collaboration with the Sarajevo Academy of Music, the Manhattan Quartet established the Sarajevo Chamber Music Festival.

Since 1989 the Manhattan String Quartet has hosted annual teaching and performing conferences in the United States and Europe for pre-professional quartets and amateur players.

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Bartok: String Quartet No. 1,Op. 7

June 12-18, 2017at Colgate University in Hamilton, NY

June 19-25, 2017at Seattle Pacific University in Seattle, WA

STRING QUARTET CONFERENCE

KentMusic offers experienced string players the opportunity to spend six gratifying days studying major works from the string quartet repertoire. Participants receive high-level coaching from world-class performing musicians, attend lectures and concerts by the faculty artists, and have ample time for informal quartet readings and socializing.

THE MANHATTAN STRING QUARTET

“ The group has an exceptionally bright, clear sound, technically very precise and seamless. Its interpretations had more of an intellectual burnish than the emotional quality that typifies a loft of European styles.”—The Prague Post

THE MANHATTAN STRING QUARTET PRESS ACCLAIM

“ The Manhattan String Quartet blends understanding, cohesion and sharpness to convey the breadth and brilliance of these involving works.”—TIME Magazine

“ The Manhattan String Quartet’s response to this intensely personal music is passionate and ultimately exhilarating. It is the very same refusal to soften the blow of tragedy within the music that makes listening to these performance a cathartic, deeply satisfying experience.” —The Washington Times

ABOUT KENTMUSIC Since its beginnings in Kent, Connecticut in 1989, KentMusic has enjoyed a loyal following with participants returning each year from all over the United States as well as from abroad. Returning participants and newcomers alike enjoy a friendly, welcoming atmosphere with the opportunity to refine their skills, learn new repertoire and collaborate with others, see old friends and make new ones. Enrollment is limited to ensure balanced groups and ample coaching. Advance preparation is absolutely essential for all participants.

A TYPICAL DAY AT KENTMUSICMORNINGS: Breakfast is served from 7:30 AM, followed by coaching sessions with assigned ensembles from 9:00-10:45 AM. After a coffee break, Dr. David Clampitt lectures from 11:00-12:00 on the theoretical and musicological aspects of the movement studied that day with the MSQ playing musical examples. Lunch is served from 12:00-1:00 PM.

AFTERNOONS: Coaching sessions with assigned ensembles resume from 1:45-3:45 PM. The period of free time that follows can be used for relaxation and/or more music making.

EVENINGS: Dinner is served from 6:00-7:00 PM. From 7:30-10:00 PM time is available for optional free ensembles.

DAVID CLAMPITT is a music theorist and violinist who taught at Yale University for 11 years before joining the faculty at Ohio State University, where he is Associate Professor. A founding member of the Algonquin String Quartet during his years as a violinist in New York City, he has been a regular member and occasional soloist with Orchestra of New England in New Haven and has appeared as a recitalist at Yale. He has coached and lectured at KentMusic since 1990 and has also given his popular lecture/demonstrations with the

Manhattan String Quartet in New York City and in Europe.

ADDITIONAL FACULTY (for session at Colgate University) include Michael Emery, violinist (faculty Skidmore College); Austin Hartman, violinist (Biava Quartet); Kaethe Jarke, cellist (Shanghai Quartet); Joel Pichon, violinist (faculty Smith College); and Liuh-Wen Ting, violist (Meridian Quartet).

All KentMusic coaches are highly regarded chamber musicians with extensive performance and coaching experience. Unique to KentMusic, all coaches are current or former members of internationally renowned string quartets.

Hailed by the Boston Globe as “a national treasure,” the MANHATTAN STRING QUARTET is celebrating its 47th season. Well known for performances of 20th-century “classics,” the Manhattan Quartet has established a significant international reputation with regular concert appearances throughout North America, Europe, Latin America and Asia. After a series of concerts in Moscow and Leningrad in the fall of 1985, the Quartet became the first American classical ensemble to give a full tour of the Soviet Union under that era’s new cultural agreement. Their first sold-out series of performances in 1986

was followed by an equally successful tour in 1989. In 2005, the Quartet made its first tour of Asia and played to sold-out houses in Nagoya and Tokyo, Japan. Notable among its many recordings is the complete cycle of 15 Shostakovich string quartets that TIME Magazine called “One of the most important musical events of 1991.”

The group has been Quartet-in-Residence at Colgate University since 1988 and has held similar posts at the Manhattan School of Music, Cornell University, Grinnell College, Connecticut’s Music Mountain Festival and Michigan’s Interlochen National Music Camp (for 22 summers). In 2011, in collaboration with the Sarajevo Academy of Music, the Manhattan Quartet established the Sarajevo Chamber Music Festival.

Since 1989 the Manhattan String Quartet has hosted annual teaching and performing conferences in the United States and Europe for pre-professional quartets and amateur players.

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Bartok: String Quartet No. 1,Op. 7

June 12-18, 2017at Colgate University in Hamilton, NY

June 19-25, 2017at Seattle Pacific University in Seattle, WA

STRING QUARTET CONFERENCE

KentMusic offers experienced string players the opportunity to spend six gratifying days studying major works from the string quartet repertoire. Participants receive high-level coaching from world-class performing musicians, attend lectures and concerts by the faculty artists, and have ample time for informal quartet readings and socializing.

THE MANHATTAN STRING QUARTET

“ The group has an exceptionally bright, clear sound, technically very precise and seamless. Its interpretations had more of an intellectual burnish than the emotional quality that typifies a loft of European styles.”—The Prague Post

THE MANHATTAN STRING QUARTET PRESS ACCLAIM

“ The Manhattan String Quartet blends understanding, cohesion and sharpness to convey the breadth and brilliance of these involving works.”—TIME Magazine

“ The Manhattan String Quartet’s response to this intensely personal music is passionate and ultimately exhilarating. It is the very same refusal to soften the blow of tragedy within the music that makes listening to these performance a cathartic, deeply satisfying experience.” —The Washington Times

ABOUT KENTMUSIC Since its beginnings in Kent, Connecticut in 1989, KentMusic has enjoyed a loyal following with participants returning each year from all over the United States as well as from abroad. Returning participants and newcomers alike enjoy a friendly, welcoming atmosphere with the opportunity to refine their skills, learn new repertoire and collaborate with others, see old friends and make new ones. Enrollment is limited to ensure balanced groups and ample coaching. Advance preparation is absolutely essential for all participants.

A TYPICAL DAY AT KENTMUSICMORNINGS: Breakfast is served from 7:30 AM, followed by coaching sessions with assigned ensembles from 9:00-10:45 AM. After a coffee break, Dr. David Clampitt lectures from 11:00-12:00 on the theoretical and musicological aspects of the movement studied that day with the MSQ playing musical examples. Lunch is served from 12:00-1:00 PM.

AFTERNOONS: Coaching sessions with assigned ensembles resume from 1:45-3:45 PM. The period of free time that follows can be used for relaxation and/or more music making.

EVENINGS: Dinner is served from 6:00-7:00 PM. From 7:30-10:00 PM time is available for optional free ensembles.

CONFERENCE ACTIVITIESCOACHED QUARTETS At the core of KentMusic is the opportunity to receive intensive, daily coaching on Bartok’s String Quartet No. 1, Op. 7, which all participants must prepare in advance. Coaches rotate among quartets that are carefully matched and assigned each day.

CONCERT SERIES Outstanding chamber music concerts featuring the Manhattan String Quartet and guest artists.

INFORMAL ENSEMBLES Explore repertoire and meet the other players in self-organized, daily reading sessions.

LECTURE/DEMONSTRATIONS Daily, in-depth exploration of the work being studied with Dr. David Clampitt and the Manhattan String Quartet. A KentMusic highlight!

Come join us and refine your quartet playing at KentMusic!

“ I’ve been to a lot of chamber music workshops and KentMusic is truly special. The members of the Manhattan Quartet are not only superb performers, but they are all great coaches with the rare ability to illuminate the music while inducing us to play at the top of our capacity.”

COMMENTS FROM KENTMUSIC PARTICIPANTS

“ KentMusic is extraordinary in its achievement of high standards without competition.”

“ A fine week, worth every penny. I plan to return next year!” “ What a great week it was! For me

as well as everybody I talked to.”

“ Thank you for the wonderful week at KentMusic. I feel so lucky to be able to delve into this extraordinary music and study it with such a marvelous group of coaches. I think we all get a tremendous amount of satisfaction from the experience in large part because all of you approach the process with such enthusiasm and passion.”

WEINSTOCK MEMORIAL FUNDOur modest Scholarship Fund allows us to help younger players who would otherwise be unable to attend KentMusic. Your contributions to this fund are very much appreciated. Please make your tax-deductible gift payable to “MSQ Enterprises” and mail with your application form.

FEES AND APPLICATION PROCEDUREEARLY ACCEPTANCE DEADLINE: ................. March 10, 2017EARLY ACCEPTANCE NOTIFICATION: ..............April 7, 2017REGISTRATION DEADLINE: .............................April 21, 2017

PAYMENT IN FULL DUE: ............................. May 1, 2017No refunds for cancellations after May 1, 2017.

The faculty welcomes experienced string players: amateur, pre-professional, and professional. Acceptance will depend upon the number of applicants and the need for balanced instrumentation in assembling the participants into full quartets of similar ability.

Fees include a non-refundable application deposit of $300 per participant and $150 per guest/spouse. In the case of applicants who are not accepted, deposits will be returned.

For Resident Participants, meals begin with dinner on Monday and end with lunch on Sunday. For Commuter Participants, dinner on Monday and daily lunch from Tuesday through Sunday are included in your fee.

NEW TO KENTMUSIC: Welcome! Please include with your application a separate sheet that BRIEFLY describes your technical proficiency, chamber music experience, and workshops attended.

April 9, 2017 New York, NY

String Quartet Workshop Beethoven: Quartet in A major

Op. 18 No. 5

January 7-14 and January 14-21, 2018

Vienna, AustriaHaydn in Vienna Conference

Work to be announced

For KentMusic-Colgate: Ivy A. Turner Tel: 617-308-4897 Email: [email protected]

For KentMusic-Seattle: Becky Rodman Tel: 360-540-6245 Email: [email protected]

INQUIRIES AND ADDITIONAL INFORMATION:

UPCOMING MANHATTAN QUARTET WORKSHOPS/CONFERENCES

www.ManhattanStringQuartet.com

TO APPLY, fill out the Application Form and mail it with your deposit check to:

Manhattan String Quartet c/o Karan Spanard 135 Willow Street Suite 803 Brooklyn, NY 11201

JUNE 12-18, 2017 AT COLGATE UNIVERSITY IN HAMILTON, NY

JUNE 19-25, 2017 AT SEATTLE PACIFIC UNIVERSITY IN SEATTLE, WA

The Colgate University Campus is set in the rolling hills of the Chenango Valley in central New York State. A nationally known center of intellectual achievement, Colgate offers a beautiful setting with ideal rehearsal, concert, lodging and dining facilities as well as walking trails and athletic facilities. The closest airports are Syracuse (1 hour) and Albany (2 hours). Hamilton is a scenic 4-5 hour drive from New York City or Boston. We assist in arranging carpools and airport vans.

Accommodations are in Colgate University’s Residence Halls, offering single and double rooms with shared bathrooms. Laundry facilities and common lounge areas are available in each residence hall. All buildings are within walking distance in a beautiful setting with gentle hills.

KENTMUSIC-COLGATE FEES:

Resident Coached Participant: Single Room $1,075 / Double Room $975

Coaching, lectures, free-playing, lodging, meals, MSQ concerts, receptions

Commuter Coached Participant $675 Coaching, lectures, free-playing, 1 dinner,

6 lunches, MSQ concerts, receptions

Non-Coached Participant/Auditor: Single Room $875 / Double Room $775

Lectures, free-playing, lodging, meals, MSQ concerts, receptions. May audit coaching sessions.

Located in a residential neighborhood on the north slope of Queen

Anne Hill and just 10 minutes from downtown, Seattle Pacific University’s 43-acre city campus borders the Lake Washington Ship Canal and boasts majestic trees, open lawns, beautiful gardens, and views of the Cascade Mountains.

Accommodations are in spacious suite-style units with single bedrooms, private and semi-private baths, plus a shared kitchen and living room. Laundry facilities are available in each suite.

For those who are local commuters, SPU offers plenty of free parking.

KENTMUSIC-SEATTLE FEES: Resident Coached Participant: Single/Double room: Private bath $1,250 / Semi-private bath $1,150

Coaching, lectures, free-playing, lodging, meals, MSQ concerts, receptions

Commuter Coached Participant: $775 Coaching, lectures, free-playing, 1 dinner,

6 lunches, MSQ concerts, receptions

Non-Coached Participant/Auditor: Single/Double room: Private bath $1,050 / Semi-private bath $950

Lectures, free-playing, lodging, meals, MSQ concerts, receptions. May audit coaching sessions.

Non-Coached Commuter: $600 Lectures, free-playing, 1 dinner, 6 lunches, concerts,

receptions. May audit coaching sessions.

Non-Playing Guest or Spouse: Single Room, Private bath $725 Double Room, Private bath $625

Lodging, meals, lectures, concerts, receptions

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CONFERENCE ACTIVITIESCOACHED QUARTETS At the core of KentMusic is the opportunity to receive intensive, daily coaching on Bartok’s String Quartet No. 1, Op. 7, which all participants must prepare in advance. Coaches rotate among quartets that are carefully matched and assigned each day.

CONCERT SERIES Outstanding chamber music concerts featuring the Manhattan String Quartet and guest artists.

INFORMAL ENSEMBLES Explore repertoire and meet the other players in self-organized, daily reading sessions.

LECTURE/DEMONSTRATIONS Daily, in-depth exploration of the work being studied with Dr. David Clampitt and the Manhattan String Quartet. A KentMusic highlight!

Come join us and refine your quartet playing at KentMusic!

“ I’ve been to a lot of chamber music workshops and KentMusic is truly special. The members of the Manhattan Quartet are not only superb performers, but they are all great coaches with the rare ability to illuminate the music while inducing us to play at the top of our capacity.”

COMMENTS FROM KENTMUSIC PARTICIPANTS

“ KentMusic is extraordinary in its achievement of high standards without competition.”

“ A fine week, worth every penny. I plan to return next year!” “ What a great week it was! For me

as well as everybody I talked to.”

“ Thank you for the wonderful week at KentMusic. I feel so lucky to be able to delve into this extraordinary music and study it with such a marvelous group of coaches. I think we all get a tremendous amount of satisfaction from the experience in large part because all of you approach the process with such enthusiasm and passion.”

WEINSTOCK MEMORIAL FUNDOur modest Scholarship Fund allows us to help younger players who would otherwise be unable to attend KentMusic. Your contributions to this fund are very much appreciated. Please make your tax-deductible gift payable to “MSQ Enterprises” and mail with your application form.

FEES AND APPLICATION PROCEDUREEARLY ACCEPTANCE DEADLINE: ................. March 10, 2017EARLY ACCEPTANCE NOTIFICATION: ..............April 7, 2017REGISTRATION DEADLINE: .............................April 21, 2017

PAYMENT IN FULL DUE: ............................. May 1, 2017No refunds for cancellations after May 1, 2017.

The faculty welcomes experienced string players: amateur, pre-professional, and professional. Acceptance will depend upon the number of applicants and the need for balanced instrumentation in assembling the participants into full quartets of similar ability.

Fees include a non-refundable application deposit of $300 per participant and $150 per guest/spouse. In the case of applicants who are not accepted, deposits will be returned.

For Resident Participants, meals begin with dinner on Monday and end with lunch on Sunday. For Commuter Participants, dinner on Monday and daily lunch from Tuesday through Sunday are included in your fee.

NEW TO KENTMUSIC: Welcome! Please include with your application a separate sheet that BRIEFLY describes your technical proficiency, chamber music experience, and workshops attended.

April 9, 2017 New York, NY

String Quartet Workshop Beethoven: Quartet in A major

Op. 18 No. 5

January 7-14 and January 14-21, 2018

Vienna, AustriaHaydn in Vienna Conference

Work to be announced

For KentMusic-Colgate: Ivy A. Turner Tel: 617-308-4897 Email: [email protected]

For KentMusic-Seattle: Becky Rodman Tel: 360-540-6245 Email: [email protected]

INQUIRIES AND ADDITIONAL INFORMATION:

UPCOMING MANHATTAN QUARTET WORKSHOPS/CONFERENCES

www.ManhattanStringQuartet.com

TO APPLY, fill out the Application Form and mail it with your deposit check to:

Manhattan String Quartet c/o Karan Spanard 135 Willow Street Suite 803 Brooklyn, NY 11201

JUNE 12-18, 2017 AT COLGATE UNIVERSITY IN HAMILTON, NY

JUNE 19-25, 2017 AT SEATTLE PACIFIC UNIVERSITY IN SEATTLE, WA

The Colgate University Campus is set in the rolling hills of the Chenango Valley in central New York State. A nationally known center of intellectual achievement, Colgate offers a beautiful setting with ideal rehearsal, concert, lodging and dining facilities as well as walking trails and athletic facilities. The closest airports are Syracuse (1 hour) and Albany (2 hours). Hamilton is a scenic 4-5 hour drive from New York City or Boston. We assist in arranging carpools and airport vans.

Accommodations are in Colgate University’s Residence Halls, offering single and double rooms with shared bathrooms. Laundry facilities and common lounge areas are available in each residence hall. All buildings are within walking distance in a beautiful setting with gentle hills.

KENTMUSIC-COLGATE FEES:

Resident Coached Participant: Single Room $1,075 / Double Room $975

Coaching, lectures, free-playing, lodging, meals, MSQ concerts, receptions

Commuter Coached Participant $675 Coaching, lectures, free-playing, 1 dinner,

6 lunches, MSQ concerts, receptions

Non-Coached Participant/Auditor: Single Room $875 / Double Room $775

Lectures, free-playing, lodging, meals, MSQ concerts, receptions. May audit coaching sessions.

Located in a residential neighborhood on the north slope of Queen

Anne Hill and just 10 minutes from downtown, Seattle Pacific University’s 43-acre city campus borders the Lake Washington Ship Canal and boasts majestic trees, open lawns, beautiful gardens, and views of the Cascade Mountains.

Accommodations are in spacious suite-style units with single bedrooms, private and semi-private baths, plus a shared kitchen and living room. Laundry facilities are available in each suite.

For those who are local commuters, SPU offers plenty of free parking.

KENTMUSIC-SEATTLE FEES: Resident Coached Participant: Single/Double room: Private bath $1,250 / Semi-private bath $1,150

Coaching, lectures, free-playing, lodging, meals, MSQ concerts, receptions

Commuter Coached Participant: $775 Coaching, lectures, free-playing, 1 dinner,

6 lunches, MSQ concerts, receptions

Non-Coached Participant/Auditor: Single/Double room: Private bath $1,050 / Semi-private bath $950

Lectures, free-playing, lodging, meals, MSQ concerts, receptions. May audit coaching sessions.

Non-Coached Commuter: $600 Lectures, free-playing, 1 dinner, 6 lunches, concerts,

receptions. May audit coaching sessions.

Non-Playing Guest or Spouse: Single Room, Private bath $725 Double Room, Private bath $625

Lodging, meals, lectures, concerts, receptions

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dvan

ced

(stro

ng te

chni

que,

fast

conc

ert t

empo

and

in tu

ne)

Inte

rmed

iate

(goo

d or

impr

ovin

g te

chni

que,

reas

onab

le te

mpo

) B

egin

ner (

stops

and

star

ts, sl

ow te

mpo

for t

echn

ical r

easo

ns)

Begi

nner

s are

enco

urag

ed to

cons

ider

atte

ndin

g as

a N

on-C

oach

ed P

artic

ipan

t

CH

AM

BER

MU

SIC

EX

PER

IEN

CE:

A

lot

S

ome

N

ot M

uch

N

one

For V

iolin

ists

: I a

m m

ost c

omfo

rtab

le p

layi

ng:

1st

Vio

lin

2nd

Vio

lin

Bot

h

FOR

PR

OFE

SSIO

NA

L Q

UA

RTE

TS:

Plea

se li

st th

e ot

her m

embe

rs o

f you

r gro

up:

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

_

AR

E YO

U N

EW T

O K

ENTM

USI

C?

Y

es

Plea

se in

clud

e w

ith y

our a

pplic

atio

n a

sepa

rate

shee

t tha

t BR

IEFL

Y de

scrib

es y

our

tech

nica

l pro

ficie

ncy,

cham

ber m

usic

exp

erie

nce,

and

wor

ksho

ps a

ttend

ed.

APP

LYIN

G A

S: C

oach

ed P

artic

ipan

t

Non

-Coa

ched

Par

ticip

ant/A

udito

r

HO

USI

NG

PR

EFER

ENC

E:

Roo

m o

n ca

mpu

s

Com

mut

er

Com

ing

with

gue

st/sp

ouse

, nam

e: _

____

____

____

____

____

____

____

___

ACC

OM

MO

DAT

ION

S:

Sin

gle

D

oubl

e, sh

are

with

___

____

____

____

____

____

____

____

___

Spec

ial n

eeds

, inc

ludi

ng d

ieta

ry re

stric

tions

:__

____

____

____

____

____

____

____

____

____

____

____

____

____

____

___

KEN

T M

USI

C 20

17 A

PPLI

CATI

ON

FO

RM (p

leas

e pr

int c

lear

ly)

APP

LYIN

G T

O:

June

12-

18, 2

017

(Col

gate

)

June

19-

25, 2

017

(Sea

ttle

)

Plea

se m

ake

chec

ks p

ayab

le to

: MSQ

Ent

erpr

ises

, Inc

.

APPL

ICAT

ION

DEP

OSI

T (r

equi

red)

$

____

____

Con

trib

utio

n to

the W

eins

tock

Mem

oria

l Sc

hola

rshi

p Fu

nd (t

ax-d

educ

tible)

$

____

____

TOTA

L AM

OU

NT

EN

CLO

SED

$

____

____

Rela

tion,

pho

ne

Inst

rum

ent _

____

____

____

____

____

____

____

____

____

__

Your

Nam

e ___

____

____

____

____

____

____

____

____

____

Mai

ling

Addr

ess _

____

____

____

____

____

____

____

____

__

City

, Sta

te, Z

ip C

ode

____

____

____

____

____

____

____

___

Phon

e: (h

ome)

___

____

____

____

____

(cell

) ___

____

____

__

E-M

ail: _

____

____

____

____

____

____

____

____

____

____

_

Emer

genc

y C

onta

ct: _

____

____

____

____

____

____

____

___

____

____

____

____

____

____

____

____

____

____

____

__

Plea

se pr

int c

learly

Cut

her

e and

retu

rn fo

rm.