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POE WORCESTER 08 - Application Form

1. Contact Information

Student Name_______________________________Email_____________________________

Home Phone:___________________________Cell Phone_____________________________

Street Address________________________________________________________________

City______________________________State________Zip____________________________

Gender_______ Date of Birth _______________

Parent/Guardian Name(s) _______________________________________________________

Parent/Guardian Address (if different)

Street ______________________________________________________________________

City___________________________________State________Zip_______________________

Email_____________________________________Telephone__________________________

2. Travel & Lodging Information

I would arrive by plane_____ bus _____ train_____ car_____

I would require transportation from airport, bus or train station to the college. Yes____ No____

Special needs & accommodations such as dietary restrictions, etc.

____________________________________________________________________________

Roomate Request_____________________________________________________________

3. Musical Background Information

POE’s attended in the past ______________________________________________________

Level of Study:

Organ - Beginner____ Intermediate_____ Piano - Beginner____ Intermediate_____

Number of years of study - 0rgan (if any) ______ Piano _____

Current organ teacher (if applicable) ______________________________________________

Current piano teacher (if applicable) ______________________________________________

Piano Repertoire - List examples of compositions you have studied and are currently studying:

Title:_________________________________________Composer_______________________

Would you like to perform on the student piano recital on Tuesday night? Yes____ No____

Students of all levels are welcome and encouraged to perform on the recitals and in the masterclasses; however, participation in these events is entirely optional.

Organ Repertoire - List examples of compositions you have studied and are currently studying:

Title:_________________________________________Composer_______________________

Would you like to perform on the student organ recital on Friday night? Yes____ No____

Beginning students may perform compositions studied during the POE week. All students wishing to participate will be accommodated.

Masterclass Performance - List organ composition(s) you would be prepared to play in one of the masterclasses:

Title:_________________________________________Composer_______________________

Every effort will be made to accommodate as many performances in the masterclasses as possible, but time contraints may prevent honoring every request to play.

4. Parent/Guardian Signature___________________________ Date_____________

Please send application form postmarked by May 1, 2008 to:

Worcester Chapter AGO
P.O. Box 20208
Worcester, MA 01602

You will be notified by May 15, 2008 of the status of your application. If accepted to the POE Worcester 08, payment of the $450 registration fee will be due June 1, 2008.

To apply for scholarship assistance, please attach a separate letter stating the case for your need. Students are also encouraged to approach their local AGO Chapters and other institutions for financial aid.