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Keyboard Gymnastics of Phoenix Ensemble Event

On-line Registration

Fee per Student: $7.00 (if not pre-registered for at least one of the following events: Technic, Sight Reading, Ear Training, Theory)

Fee per Student: $5.00 (if pre-registered for at least one of the following events: Technic, Sight Reading, Ear Training, Theory)

 

ATTENTION:  The Submit button is not currently working.  You may still fill out this form, then Select All, Copy, and Paste into an e-mail and send to Liz Owens at: lizmo1@juno.com . If you have a PayPal account, you may make a payment directly to Keyboard Gymnastics using the same e-mail address (lizmo1@juno.com).

Teacher Name:      Phone: 

E-Mail:      Number of Students Entered: 

I have read and agree to abide by all participation requirements:  Yes No

I own a Keyboard Gymnastics Program Manual: Yes  No

Please complete for each student

Student 1

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 2

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 3

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 4

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 5

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 6

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 7

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 8

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 9

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 10

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 11

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 12

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 13

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

Student 14

Student's Name:    Age/Grade:    Part playing:

Title:   Composer:   Length:

Partner Name:     Is partner being adjudicated? Yes No

Ensemble Type: Concerto  Duet Trio

How will you pay for this student?    Check   Pay Pal   Already pre-paid

 

ATTENTION:  The Submit button is not currently working.  You may still fill out this form, then Select All, Copy, and Paste into an e-mail and send to Liz Owens at: lizmo1@juno.com . If you have a PayPal account, you may make a payment directly to Keyboard Gymnastics using the same e-mail address (lizmo1@juno.com).