2018 GCCAHS Scholarship Competition Application

2018 GCCAHS Scholarship Competition Application
Student's Name

First Name Last Name
Student's Birthdate

Month Day Year
Date
Age on October 7, 2018
Phone Number

Area Code Phone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Select a Category

Beginner Division (12 years old and under) Junior Division ( 15 years old and under) Senior Division (18 years old and under)
Performance Repertoire Selection #1 (Title, Composer, Approximate performance time)
Total performance time of chosen repertoire should not exceed 10 minutes
Performance Repertoire, Optional 2nd Selection (Title, Composer, Approximate performance time)
I verify that my Harp Teacher has approved my repertoire and my ability to perform for the Scholarship Competition *

Yes
Harp Teacher's Full Name

First Name Last Name
Harp Teacher's email
example@example.com
Harp Teacher's Mailing address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
I understand and agree that if I am selected as a winner in my category, I am required to participate in the winner’s recital at Harp Day, November 4, between 1-5pm (taking place at the Lyon and Healy Harp Factory in Chicago). I also understand and agree to bring my own harp to the competition with the option to make my own arrangements to share a harp with another participant.
Student or Parent Signature

Clear
Online Application Fee. When you click submit you will be taken to the GCCAHS Paypal payment portal. *
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Scholarship Competition Application Fee $ 35.00

2018 GCCAHS Student Membership $ 10.00
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