American Guild of Organists - Duquesne University Chapter

Registration Form

Click here to print this form. Fill it out and mail it as per the instructions below.

Enrollment Requirements

Age for application is 13-18 years. The POE committee may choose to grant special consideration on an individual basis for admission of a potential registrant whose age or training is different than the guidelines.

Applications

The registration fee includes a one-year, $30.00 student membership in the American Guild of Organists. Deadline for application is May 15, 2004. Register early as enrollment is limited. Any cancellations received before the deadline will be refunded. All cancellations after the May 15 deadline will require a $25 cancellation fee. No cancellations can be made after June 15, 2004.

Application Form

Name: _________________________________

Address: _______________________________

City / State/ Zip: _________________________

Phone: _________________________________

Email: _________________________________

Date of Birth: _______________ Gender: M F

Signature of Parent or

Guardian: _______________________

Relationship of P/G: ______________________

P/G Phone: _____________________________

P/G Email: ______________________________

Special Needs: ___________________________

Piano Studies:

Beginner_____Intermediate_____Advanced_____

Organ Studies:

Beginner_____Intermediate_____Advanced_____

Represenative list of repertoire

(Attach separate sheet)

List of possible repertoire to be studied/performed at POE (Attach separate sheet)

Please send this form with your check of $280 payable to:

DU POE 2004
c/o Jeffrey M. Alban
4405 Bayard St. (Apt)
Pittsburgh , PA   15213

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American Guild of Organists - Duquesne University Chapter