The 21st Annual Summer Music Festival at Walnut Hill
July 26 to August 17, 2012
STUDENT DATA FILE
Please fill this form in either
Chinese or English and
return it by email or Fax as soon as possible.
Full tuition
is due before May 30, 2012
1 recent photo (E photo acceptable) required,
Send everything to:
Dr. Catherine Tan Chan, Foundation
for Chinese Performing Arts
3 Partridge Lane, Lincoln, MA 01773,
USA
Tel: 781-259-8195, Fax: 781-259-9147
Email: Foundation@ChinesePerformingArts.net,
Website: www.ChinesePerformingArts.net
A: Personal Information
1. Name (English) ___________(Chinese if any) ____Male/Female: ____
First Name prefered: _____Date of Birth (MM/DD/YEAR)______Age: ___
Email (please print) _____________Tel: ____
2. Name(s) of Parent(s): __________Tel: _____Mobile phone: ________
Mailing Address (English): _______________
Mailing Address (Chinese): ________Email: ____________
B: Music Background:
1. Major ______ Teacher's Name(s): ______
2. second instrument that you would like to have lessons on: _______ Teacher's Name(s) ______
3. School currently attending: __________ Grade ________
4. Awards or honors received: (use separate sheets if needed)
__________
___________
5. List of repretoires for private lessons:
Each student should have at least 4 well-prepared memorized pieces to be worked on for private lessons. This music festival provides a rare opportunity for talented students like you to work directly with world-renowned musicians on a one-on-one daily basis. The more preparation you have, the more you will benefit from it. Also prepare some chamber and concerto pieces that may be useful for chamber ensembles. Everyone will be assigned to chamber groups learning new pieces. There will be a 5-7 min audition tentatively scheduled on Friday, July 27, 1-5 pm. If you are taking lessons for the second instrument (no extra charge), it will be auditioned also. Bring the music scores and the parts with you. Based on the music you listed here and your audition, the faculty members will finalize the chamber group assignment accordingly.
Composer: Name of the piece
a. ____________
b. ____________
c. ____________
d. ____________
e.____________
6. Chamber music you have learned. List the recent ones or your favorates if the list gets too long.
Composer: Name of the piece
a. ____________
b. ____________
c. ____________
d. ____________
7. Do you want to take lessons of your second instruments? If “yes”, you have to work hard and will be treated as if it is your “major” also. It has to be auditioned. There is no extra charge for taking lesson on a second instrument. ____ Yes _____ No
If YES, please list: Composer: Name of the piece:
a. ____________
b. ____________
c. ____________
d. ____________
8. Any request or suggestion about your music program ? Any favorite chamber music you like to learn?
____________
9. Are you going to participate in piano concerto competition? __ Yes __ No __ Maybe
10. Upon faculty members’ approval, do you like to have a solo recital in addition to student gala concerts on August 16, 2012? __ Yes ____ No ___ Not Sure
If Yes, what will be your program?
C: Travel Information: (Please indicate if you are traveling with a group of students and do not know the details yet, or, if your are waiting for your visa application, We will arrange for the pick up/drop off.)
1. Arrival Date and Time: (check in July 26, 2012, 1-5 pm) ____ Time ______
by Air: Flight Number: _________
by Train: Train Station: _____ by Bus: Bus Station: ____
by Car: Driven by: ______
2. Departure Date and Time: (check out August 17, 2012, 8 AM - 4 PM) ___ Time____
by Air: Flight Number: __________
by Train: Train Station _____ by Bus: Bus Station: ____
by Car: Pick up by: ________
3. Do you need to be picked up/dropped off from the airport or train/bus
stations?
____ Yes _____ No
D: Medical Information (please bring your updated immunization records with you):
1. Do you have any medical insurance coverage that is effective in the United States? Bring your medical immunization record with you if possible.
a. __ Yes.
Medical Insurance Carrier: ________,
Policy Number: ________
It is insured under the name of ____
b. ___ No.
2. Are you allergic to any medication, such as penicillin? __ Yes __ No __ Unknown
3. Are you allergic to any types of food?
_____ Yes, Name(s) of the food: ______
______No _____ Unknown
4. Any medical conditions that we should know about? Please indicate the date of any operations or serious injuries, or any chronic or recurring illness. Please notify us if you have exposed to any communicable disease during the three months prior to this festival attendance.
FOR THOSE WHO ARE ON MEDICATION, DO NOT FORGET TO BRING YOUR OWN MEDICINE.