THE FOURTH JAPAN HONG KONG INTERNATIONAL MUSIC COMPETITION Young Artist Japan Hong Kong Musicians Alliance Room 1104, Crawford House 70 Queen's Road Central Central, Hong Kong Hong Kong SAR Tel : +852 2961 4276 Application Form for entry to The 4th Japan-Hong Kong International Music Competition 1a. Participant's Name / Nationatlity / Date of Birth / Sex (in Alphabet) Name* : (in Chinese/ Japanese) <Place your photo> Write your Name/ Date of Birth on the back Nationality* : (Month/Date/Year) Date of Birth*: Age* : Sex* : Male Female 1b. Participant's Address / Phone Number / Email Address* : + Phone No* : - + Mobile No : - Email* : 2. Participant's Background Information Name of School* : Grade / Year * : Name of Music Instructor* : Instructor's Contact Address* : Phone No* : + - 3. Competition Entry Information (In case of "Multiple entry", please fill out separate form for each entry.) Section* : Piano Multiple Entry : Fee* (HK$) : Violin Other Class $400 $500 Flute Class* : Junior A Junior B Intermediate Advanced Professional Category (Check box if applying) $700 $900 Repertoire* : (Max. two pieces) Date : 7/11 7/12 7/19 7/18 ( 7/11, 7/12 : Piano 7/18, 7/19 : Violin/ Flute ) 1. Composer : 2. Composer : Duration : Duration : OFFICE USE ONLY 4. Signature* : Applicant No : Single Group Payment : Signature of Participant (or Guardian) Date *Required information field is indicated by * mark. *Application Form will not be accepted if any of the above required information is missing. Y N Check No : Method : Check Bank
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