Joseph Bologne International Piano Competition Registration Form

Name*

First Last

Your Email*

Parent's Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

School Grade*

School Name*

Piano Teacher Name*

First Last

Piano Teacher Email

Would you like to use your competition performance as an audition for Elon’s Music Program

Seniors Only

Total time of performance repertoire*

Must be no more than 20 minutes, strictly enforced.

Required Bologne Piece*

Additional repertoire

List by composer, Title, length for each; use a separate line for each entry