Application Form for St. Petersburg International Music Academy

Application form

APPLICANT INFORMATION

First Name:

Last Name:

Instrument:

Date of Birth (MM/DD/YYYY):

Age (as of 1/1/2025):

Sex:

Address:

City:

Country:

State:

Zip:

Phone:

Cell:

Email:

School in 2015/16:

Grade in 24/25:

Are you going to be a resident?

Yes No

Roommate preference:

Special requests:

PARENT/GUARDIAN INFORMATION

Mother/Guardian Name:

Address:

Phone:

Cell:

Email:

Employer:

Work Phone:

Father/Guardian Name:

Address:

Phone:

Cell:

Email:

Employer:

Work Phone:

MUSICAL STUDIES (if you need more space, please use the other side to answer any of the following)

Name of Private Teacher:

Private Teacher's email:

Number of Years with this Teacher:

Total Years of Private Study:

Are you a member of an Orchestra? If so, which one?

What is your Chamber Music Experience?

What Chamber Music have you learned?

BIOGRAPHICAL INFORMATION

Please write a short 1 page bio including experience, achievements, education, current and former teachers, and repertoire (solo, orchestral and chamber music).

NON-REFUNDABLE APPLICATION FEE OF $50
Application dead-line June 1, 2019.

Upon notification of acceptance, a $350 deposit must be submitted with the balance due by July 1, 2019.

No refunds will be made after July 10, 2019.