Piano Camp Registration Form                                                                     JULY 10-18, 2004
Young Artist Piano Camp is open to students 12-18 years of age. Because we value the amount of individual time studetns receive in their stay at camp, there is a capacity of 60 students allowed. Please understand that if we receive an application after the capacity has been reached, the student cannot be admitted. The dealine for receiving applications is May 15, 2004.
Fee: $650.00 for room, board, and tuition. A $100 deposit must be sent with the application. This deposit is non-refundable after May 15, 2004. Balance is due July 10th. Call Angela Ringsmuth at 320-493-3465 or e-mail her at pianocamp@musician.org with questions. Make checks payable to Central Minnesota Music School (CMMS) and mail to 823 1st street South, P.O. Box 162, St. Cloud, MN 56302, ATTN: Young Artist PIano Camp.

Name__________________________________________Age________Sex____________

Address__________________________________City__________State_____Zip________

Parents____________________________________________Phone (      )_____________

Length of Study _____years. Preferred Roomate(s)?________________________________

Name of Piano Teacher________________________________Phone (      )_____________

Preferred Clinician (for private lessons - put 1st and 2nd choice):  Dr. Nuguid___ Dr. Rieppel___ Dr. Wirth___ Dr. Zins___
Possible Participation in (just one, please):       Concerto Competition __        Master Class with Mordecai Shehori __
Performance Piece__________________________________   Repertoire for Study________________________________