Solo Division
Please select the solo, if any, that the student will be participating in.
Duet Division
Concerto Division
Student's Name *
Student's Name
Student's Contact # *
Student's Contact #
Date of Birth *
Date of Birth
Teacher's Name *
Teacher's Name
Teacher's Address *
Teacher's Address
Teacher's Phone Number *
Teacher's Phone Number
Duet Division Only
Fill out just one form per pair!
Second Student's Name
Second Student's Name
Second Student's Phone
Second Student's Phone
Date of Birth of Second Student
Date of Birth of Second Student
If performing more than one piece or movement, please number 1, 2, etc.
Please use a separate line for each entry
(Minutes & Seconds)
Composer *

Please note: Programs will run between 10:00 am and 5:30 pm. Please make these hours available. 

Please send an email to with the subject line as the students First & Last name, and a picture or scan of the birth certificate attached for age-verification purposes. All scans will be stored securely with Google Drive, and are HIPPA-compliant. The records will be securely destroyed the day after the competition.


Please return all applications by December 11, 2017, using the Cash.Me link at the bottom of the fee schedule (or alternatively, together as one check) to cover the teacher's fee and non-refundable application fees for each student as follows:

Teacher's Fee: $20 for 1-2 entries; $30 for 6-10 entries; $40 for 11-15 entries: $50 for more than 15 entries.

Solo Division I - II  $20;  III - VI  $30

Duet Division I  $40; II - III  $50

Concerto Division I  $60

Please tally your total Student & Teacher fee's, then pay the amount using the following Cash.Me link. In the "note" field of the payment page, please put  the teacher's name.  Failure to do so may result in additional processing time for your applications.$IEPF


Please note: Great care was taken in researching and selecting an online payment processor. Cash is a subsidiary of the Squarecash company, who's reputation and products have been a part of the public eye for several years now. If you cannot pay online, Please make checks payable to:


Please mail to:

Dr. Anette Guldhammer

2828 McAllister Street

Riverside, CA 92503