Title of performance piece (1)*

Composer (1) *

Title of performance piece (2) *

Composer (2) *

Title of optional performance piece 3

Composer 3

Class period (ie 2A, 6B...)

Contact Phone Number ONLY if changed in last year or new teacher

Contact Email *

Number of chairs/stands and percussion instruments needed *

Scheduling Requests, ie time, adjudication only (no competition), adj. to come to you

$75 non-refundable registration fee, PayPal