Adult Learner's

Application Form
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Please print the form below and mail it with your cheque for the participation fee to

Susan Bailey
41 Salisbury Drive
Dukinfield
Cheshire
SK16 5DL

Please make cheques payable to Adult Learners North West.

Adult Learners' Concert Performer's Application Form

Name

  

ABRSM sign-on (if applicable)

  

Address (including postcode please)

  
 
 
 

Phone

  

e-mail

  

Instrument

  

Do you need an accompanist?

  

Proposed piece - title

  

                       - composer

  

Duration (max 5 minutes, please)

  

Small Ensemble additional performers

        
Instrument        
Proposed piece - title  
                       - composer  
Do you need an accompanist?  
 

Instrument

  

Playing level

  

I enclose a cheque for £............................

Acknowledgement of applications received will be sent by e-mail unless a SAE is enclosed.

Applications close 19th June 2010

If fully subscribed before the closing date there will be a waiting list. You will be informed if this is the case when your application is received

If you have not received your acknowledgement before 25th June 2010, please either e-mail or telephone me (details on the main information page)

 

Beginners/intermediate players especially welcome!