Alpha Theta Chapter
Performing Arts Center
Frostburg State University, Frostburg MD 21532
Address:___________________________
Instrumental, Vocal, Piano Instructor
Student Signature:_____________________________
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| Delta Omicron International Music Fraternity Alpha Theta Chapter Performing Arts Center Frostburg State University, Frostburg MD 21532 |
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| Name:_____________________________ Address:___________________________ |
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| __________________________________ | ||||||||||||||||||||
| Phone:_____________________________ | ||||||||||||||||||||
| Email:_____________________________ | ||||||||||||||||||||
| School:____________________________ | ||||||||||||||||||||
| Teacher?s Name:_____________________ | ||||||||||||||||||||
| Instrument:_________________________ | ||||||||||||||||||||
| Do you have an Accompanist? Yes___ No___ | ||||||||||||||||||||
| Accompanist Name:___________________ | ||||||||||||||||||||
| Do you need an Accompanist? Yes___ No___ | ||||||||||||||||||||
| *Please note the $20 fee |
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| Name of piece:_____________________________ | ||||||||||||||||||||
| Composer:________________________________ | ||||||||||||||||||||
| Length of piece:_____________________ | ||||||||||||||||||||
| Approximate Mileage from Frostburg:_______ | ||||||||||||||||||||
| I certify that the above student is qualified to participate in the First Annual Delta Omicron Solo Competition | ||||||||||||||||||||
| _____________________ Instrumental, Vocal, Piano Instructor |
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| Parent/Guardian Signature:______________________ Student Signature:_____________________________ |
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