California Summer Music

July 3-26, 2010

Application deadline: March 31, 2010

Applicant information:

Applying for: Performance Composition

Last name:

First name:

Gender:

Instrument:

School:

Date of birth:

Address Line 1 (Number, Street, Apt/Ste):

Address Line 2 (if necessary):

City:

State:

or check here and type your country name in the box below if you are international

Zip/Postal Code:

Home phone (leave blank if you only have a cell phone):

Cell phone:

Fax:

Email:

Country of Citizenship:

Visa Type:

Visa Expiration Date:

Parent Information:

Salutation

Last name:

First name:

Check here if address, phone and fax are the same as the applicant's

Address Line 1 (Number, Street, Apt/Ste):

Address Line 2 (if necessary):

City:

State:

or check here and type your parent's country name in the box below if they are international

Zip/Postal Code:

Home phone (leave blank if they only have a cell phone):

Fax:

Cell phone:

Work phone:

Email:

Occupation:

Second Parent Information:

Salutation

Last name:

First name:

Check here if address, phone and fax are the same as the applicant's

Address Line 1 (Number, Street, Apt/Ste):

Address Line 2 (if necessary):

City:

State:

or check here and type your parent's country name in the box below if they are international

Zip/Postal Code:

Home phone (leave blank if they only have a cell phone):

Fax:

Cell phone:

Work phone:

Email:

Occupation:

Current teacher information:

Last name:

First name:

Address Line 1 (Number, Street, Apt/Ste):

Address Line 2 (if necessary):

City:

State:

or check here and type your teacher's country name in the box below if they are international

Zip/Postal Code:

Email:

Previous teachers:

How did you hear about CSM (check all that apply)?

Friend CSM Alumnus/Alumna Teacher Advertisement CSM Website CSM Brochure

Other Website:

Other

|