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Last Name |
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| Address 1 |
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| Address 2 |
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| City |
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State/Prov |
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| Postal Code |
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Telephone |
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| Country |
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| Email Address |
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| Educational background |
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| Current teacher |
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| Performing or teaching background |
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| If you are interested in playing in a master class, please indicate here with two choices of prepared repertoire (there is limited space and unfortunately not everyone can be accommodated): |
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Please submit a recording by May 15.  |
| How did you learn about the Summer Symposium? |
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| Please select |
Student
Performing Artist
Teacher
Other instrumentalist
(Instrument )
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| Age |
Under 18
18-40
Over 40 |
| Select one |
Traditional technique clinic |
Jazz technique clinic |
| Breakfast? |
$70 |
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Commuter $1,125
Commuter Deposit $500 |
Resident $1,525
Resident Deposit $500 |
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Get a 10% discount |
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I am attending with a first-time participant |
I am a college professor attending first time
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By registering for the Symposium, I acknowledge that I grant permission to the Golandsky Institute to use any photograph or video containing my likeness. Such images may be used for promotional, news, research or educational purposes.
It is your responsibility to make final payment for the program by May 15, 2009. Please make a note in your calendar.
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If you've already registered, and would like to pay your balance due, click here.
If you prefer to pay by check or money order, click here to print out this registration form and mail it in with your payment made out to The Golandsky Institute to:
The Golandsky Institute
Park West Finance Station
P O Box 20726
New York, NY 10025
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