REGIONAL APPLICATION FORM

PERSONAL DETAILS
*Gender:  
*First Name:  
*Last Name:  
*Address:  
*Suburb:  
*State:  
*Postcode:  
*Email:  
Telephone (mobile):  
*Telephone (home):  

*Date of Birth:

  

*Age at 25/4/2008:

  

*Instrument:

  
Nominated performance program for the Finals Concert, if selected:  
Last grade attained
AMEB or equivalent:
(expected minimum standard would be grade seven or equivalent):		  

Specify program of study and activity you would pursue if awarded the Regional Competition prize:
details:  
     
*Courses currently being undertaken:  
Referees
*Referee Name 1:  
*Referee Address 1:  
*Referee phone 1:  
     
Referee Name 2:  
Referee Address 2:  
Referee Phone 2:  

Previous Experience
Have you competed in the Geelong Advertiser Music Competition before?:  

*

  

ENTRANTS UNDER THE AGE OF 18

If you are under the age of 18 years on 25th April 2008, the following declaration must be completed by your Father, Mother, Guardian.


I _______________________________________________

Of_______________________________________________

am the of the entrant (above) who is

__________ years of age on 25th  April 2008.

I have read the conditions of entry as stated in the brochure and agree to the entry being made.

Signature

_______________________________________________

Date

_______________________________________________

 
 

APPLICANT’S DECLARATION

Within the period of five years immediately preceding this application to enter the competition I have resided in the municipalities of the City of Greater Geelong, Surfcoast Shire, Golden Plains Shire, Borough of Queenscliff, or the Colac Otway Shire for not less than two years. I have read the accompanying notes, rules and conditions of the 2008 Geelong Advertiser Regional Music Competition.

I hereby apply for a Geelong Advertiser Regional Music Competition, and agree to abide by the rules of the Regional Competition and accept the decision of the selection panel and the judge. I consent to be available to perform at an audition on May 18, 2008. Applicants will be notified of their audition times prior to the date.

If selected as a semi finalist I agree to play at a public semi final recital to be held in Geelong on Saturday June 14, 2008.

If selected as a Regional finalist I consent to perform in public before an adjudicator and an audience at Costa Hall, Waterfront Campus, Deakin University on the evening of Saturday, August XX, 2008.

If selected as a finalist I agree to provide a photograph and a 100 word biography of myself which may be used for publicity purposes in connection with the Competition.

Signature

_______________________________________________

Date

_______________________________________________

 
 
 

CHECKLIST: Have you?

  • Read and Understood the terms of entry?
  • Completed all of the entry form in every detail?
  • Checked the Final Concert date and ensure your availability?
  
   

ENTRIES TO BE POSTED TO
Event Coordinator
Geelong Advertiser Music Competition
GPAC
PO BOX
Geelong VIC 3220

  
How did you hear about the Geelong Advertiser Music Competition?
*    
Please specify:  
* I accept the terms and conditions of entry  
 

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