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MUSIKČ ACADEMY AT
DURHAM
APPLICATION FORM |
Your
details |
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Name |
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Photograph |
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Date of
Birth |
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Address |
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Postcode |
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Telephone |
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Fax |
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Email
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Please give the
email address which you use most frequently. All important
correspondence relating to Musike 2006 will be sent by this method, and
it is vital that we know you will read it as soon as possible |
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Instrument |
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Musical
Conservatoires / Academies / Colleges attended, with dates |
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Please ask your teacher or an eminent musician who
knows your work to provide a signed recommendation on a separate sheet
and send it to the contact below, either by fax or post, as soon as
possible.
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(Select
to confirm) |
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Curriculum Vitae copy and
paste into space provided.
or
on a separate sheet and send it to the contact
below, either by fax or post, as soon as possible |
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Repertoire you would offer |
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Fees
The fee for Musike 2006 is £700 inclusive. Students who pay by July 1st
2006 will be charged £500 onlyIf you are
selected to participate in Musike 2006 Summer Academy, you will be asked
via email to pay the fee by one of the means indicated below
Do not send any payments or account details with
this electronic form. It is not secure.
Balance
of fee due no later than August 1st, 2006.
Any supplementary material, cheques or secure
details should be sent either by fax or post when requested to the
contact below. |
Payment
methods
Cheque / Eurocheque (bank
in EC or USA only) (made payable to Musikč
Great Britain)
Sterling Draft (bank in
EC or USA only) (made payable to Musikč
Great Britain) |
Mr Trevor
Turner,
Executive Secretary,
Musikč
Academy,
Carter House,
Pelaw Leazes Lane,
Durham
DH1 1TB
England
Fax +44
(0)191-374-6001 |
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I confirm
that all of the above information is correct
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Date
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Address
for correspondence
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