Naples Music Club
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Our vision is a musically connected community where individuals can fulfill their artistic dreams.
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2012 Application For 42nd Annual Scholarship Competition
Application must be submitted electronically or postmarked by March 1, 2012. Fill in all applicable blanks.
Student Data
Last Name
(required)
First Name
(required)
Birthdate (MM/DD/YYYY)
(required)
Instrument/Voice
(required)
School
(required)
Grade
Choose One
6
7
8
9
10
11
12
(required)
Parent Data
Last Name
(required)
First Name
(required)
Spouse First Name
(required)
Street Address
(required)
City
(required)
Zip Code
33928
34101
34102
34103
34104
34105
34106
34107
34107
34108
34109
34110
34112
34113
34114
34116
34117
34119
34120
34133
34134
34135
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34138
34139
34140
34142
34143
34144
34145
34146
Other
(required)
Home Phone
(required)
Cell Phone
Email
(valid email required)
Teacher Data
Last Name
(required)
First Name
(required)
Street Address
City
Zip Code
Home Phone
(required)
Cell Phone
Email
(valid email required)
Total time of the 2 pieces to be performed may not exceed 10 minutes for Junior Division (grades 6-8) and 15 minutes for Senior Division (grades 9-12)
1. Works To Be Performed
Complete Title
(required)
Period
Baroque
Classical
Romantic
Modern
(required)
Full Name Of Composer
(required)
Min.
(required)
Sec.
(required)
I will play this piece at the Winner’s Recital if invited to play
2. Works To Be Performed
Complete Title
(required)
Period
Baroque
Classical
Romantic
Modern
(required)
Full Name Of Composer
(required)
Min.
(required)
Sec.
(required)
I will play this piece at the Winner’s Recital if invited to play
Accompanist Data (if Applicable)
Last Name
First Name
Home Phone
Cell Phone
Email
(valid email required)
Application Data
Please Check Each Of The Following Statements:
By submitting this scholarship application, I agree that I have read the scholarship application materials and accept the rules, terms and conditions of this scholarship competition. I also affirm that my teacher has approved my entry in this competition. In addition, my parent(s) approve(s) the use of my name, school, teacher name, award amount, and photos.
An entrance fee of $25 must be submitted. Make checks payable to Naples Music Club. Waivers for the $25 are possible. See rules and regulations.
Payments must be mailed to: Mrs. Jan Grundeman, Chairman, 2180 Rusty Fig Court, Naples, FL 34120, Phone: 239-353-2216, Email: jangmusic@comcast.net
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