Wufoo

Name * First Last
Email *
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone * ### - ### - ####
Cell Phone * ### - ### - ####
Workshop Choice ($380 program fee + $50 registration fee = $430) *
Woodwind: Clarinet - June 9-14, 2013 Woodwind: Oboe - June 9-14, 2013 Woodwind: Bassoon - June 9-14, 2013 Woodwind: Horn - June 9-14, 2013 Violin - June 16-21, 2013
OPTIONAL On-Campus Housing ($225 charge) *
I require on-campus housing for the Woodwind Workshop I require on-campus housing for the Violin Workshop I do not require on-campus housing
Audition Choice - Auditions will be comprised of two performances: any one movement of Bach for Violinists or Mozart for Woodwinds *
I will send or deliver a recording. I live locally and wish to audition in person (You will be contacted to arrange a date and time.)
Musical Background - Please list music most recently performed *
If you are currently a student where are you enrolled?
Name of Private Teacher if applicable
Please let us know where you learned about the Aston Magna at Brandeis Summer Workshops *
Payment Calculations

Your application fee must be received before we can act on your application and is nonrefundable upon acceptance of admission. Checks should be made payable to "Brandeis University".
Non-refundable Application Fee $50.00 $ Dollars . Cents
Workshop Tuition $380.00 $ Dollars . Cents
Optional Housing $225.00 $ Dollars . Cents
Non-refundable Application Fee

Please send your $50 application fee payable to "Brandeis University" to:
Brandeis University
Summer School - MS 085
P.O. Box 549110
Waltham, MA 02454-9110
Emergency Contact Information
Emergency Contact Name * First Last
Relationship *
Emergency Contact Home Phone * ### - ### - ####
Emergency Contact Cell Phone ### - ### - ####
Emergency Contact Email
Important Policies

Students who wish to withdraw, change courses or change status within a course must do so in accord with the Summer Program calendar. Registrants who do not do so are liable for full tuition and fees. There are no exceptions to these policies.

In submitting this form I confirm that I have taken opportunity to read the important sections cited above, understand them, and accept registration as a student at Brandeis University subject to all academic, financial and other regulations promulgated by the University and in effect during this term. You may review these policies on-line at:
http://www.brandeis.edu/studentlife/sdc/rr/index.html
Electronic Signature *
Date MM / DD / YYYY
Do Not Fill This Out

Wufoo

Payment Calculations

Non-refundable Application Fee

Emergency Contact Information

Important Policies