Western Illinois University: Macomb Campus

WIU Piano Festival Registration

 

 

Student Information

 

Student Name:

 

Student DOB:

 

Address:

 

Phone:

 

Email:

 

 

Parent Information

 

Parent/Guardian Name(s):

 

Parent/Guardian Phone:

 

Parent/Guardian Email:

 

Experience

 

Private Piano Teacher Name:

 

Choices and Payment

 

Students may sign up for one or both events

 

	Saturday Competition Students that click the Saturday Competition box will have to pay a  $20 entry fee.
	Agree to pay the $20.00 Entry Fee
	Sunday Masterclass
	Students that click the Sunday Masterclass box will have to submit a  pre-screening recording (information on how/where to send this is on the website).

Disclaimer

 

Check here if you do not give permission for pictures or name of student to be used for publicity in publications such as, but not limited to, newsletters, newspapers and magazines, and WIU brochures.

 

Parent signature for permission to enroll

 

Date:

 

Registration information

 

Please make your checks payable to "WIU Piano Festival".

Dr. Tammie Walker

School of Music

Western Illinois University

1 University Circle

Macomb, IL 61455

Email: TL-Walker4@wiu.edu

Phone: 309.298.1237