PERSONAL INFORMATION:

First A value is required. Middle A value is required.Last A value is required.

Preferred First Name A value is required.Date of Birth A value is required.Age A value is required.

Present Address (valid until this date: )

Street A value is required.City A value is required.State A value is required.Zip A value is required.

Telephone A value is required.Mobile A value is required.Fax A value is required.

Permanent Address:

Street A value is required.City A value is required.State A value is required.Zip A value is required.

Phone A value is required.

Email A value is required.

Parents' Name A value is required.Parents' Phone A value is required.

BACKGROUND INfORMATION:

Present School/Position A value is required.Current Principle Instructor A value is required.

PROGRAM STUDY:

Instrument A value is required.

Desired Instructor (please refer to the faculty on this website and choose two)

1st A value is required.2nd A value is required.

Audition Repertoire (list 2 or 3 pieces of contrasting styles)

A value is required.

Boarding (Boarders must be 18 years of age or older.)

How did you hear about this program?

If referred by faculty, please identify.

Comments/Questions

All official correspondence between the Duxbury Music Festival and the applicant, including the Festival's acceptance letter, will be via email. Each student MUST enter an email address on his/her application and make certain that the email address is currently correct and will be the proper email address from June 1 to July 19, 2012. Students must send a trial email to Stephen Deitz at s.deitz@sscmusic.org. A physical street address will be used for general correspondence purposes ONLY if the student does not have an email address to which correspondence may be sent.

I understand that the information in this application is true to the best of my knowledge and that the CD submitted is my own unedited performance. I also understand that the Duxbury Music Festival reserves the right to discharge students who have submitted false or misleading information in the application process.

If accepted as a student of the Duxbury Music Festival, I agree to abide by South Shore Conservatory regulations. I agree not to bring any alcoholic beverages or firearms onto SSC or resident premises or to possess or engage in the illegal use of drugs while a student of the Duxbury Music Festival.

Students are expected to comport themselves with basic standards of honesty and character. Plagiarism, cheating, and dishonesty in SSC related matters are prohibited and can result in a a student's dismissal without refunding any part of the fees paid.

Consent is hereby given for the applicant, while a student at the Duxbury Music Festival, to participate in SSC radio, television, and transcribed programs without compensation and for photographs taken at the Duxbury Music Festival to be used in SSC-approved publications.

I understand that a $500 tuition deposit is required by June 3, 2012.