Name of Participant *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Young Artists Catagories *

Category A (Age 6 and younger)

Category B (Age 7 and 9)

Category C (Age 10 and 12)

Category D (Age 13 and 15)

Category D (Age 16 and 18)

Category D (Age 19+, no age limited, for music lover without in major piano)

Name of Parent or Guardian

(Age under 18)

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Country

(###)

###

####

I hereby certify that the information provided in this form is complete and correct and agree to all terms and conditions. *

Yes

I understand payments are accepted online through the official website/Paypal/Zelle: *

Application Fee $110

Official Website: https://www.artcialmusicfoundation.org/apply

Paypal: artcialmusicfdn (Name: Artcial Music Foundation)

Zelle: artcialmusic@gmail.com (Name: Artcial Music Foundation)

Name on Application Payment Credit Card *

First Name

Last Name