AUCKLAND PRIMARY PRINCIPALS’ ASSOCIATION IN CONJUNCTION WITH THE NORTHERN DISTRICT KNIGHTS TEMPLAR FOUNDATION (Masonic) MUSIC COMPETITION 2015 APPLICATION FORM – send FOUR (4) copies of this 2015 FULLY completed form. Contact Details: (Please print clearly) Applicants must be Primary or Intermediate School aged children of New Zealand citizenship in the Northland, Auckland, Waikato or Bay of Plenty Regions. First name: ...................................... Family Name:................................................. Full address:.......................................................................................................... .................................................. Post code: ............... Date of birth: ...................... Home phone: (......)...................... Email: ............................................................... School:........................................................................................ Year ................. How old will you be on 1st October THIS YEAR? ......................years ................months Are you a New Zealand citizen? YES / NO (please circle one) Please attach a certified copy of your birth certificate if born in NZ or, if born in another country, provide proof of New Zealand citizenship . Applicants may apply for two (2) scholarships e.g. piano & violin or piano & cello etc but must submit separate applications. No amplified instrument allowed. All applicants must have attained Grade 5. Please attach a certified copy of your top exam result (Royal Schools or Trinity). Please indicate instrument to be played in the competition .......................................... How long have you been playing this instrument? ..................................................... Name of instrument teacher .............................................Phone (......)..................... Work to be played and composer ____________________________________________ Attach three (3) copies of music to be played. Statement from parents of guardians indicating reasons for application, and uses to which an award would be put. ............................................................................................................................ ............................................................................................................................ - 2 - Estimated cost of annual tuition OR cost of instruments, stating whether cost is for (a) (b) new / replacement instrument or repairs to instrument $............................................. Recommendation is from one of the following: (please circle one) School Principal School Music Specialist Music Teacher Out of School Hours Centre Teacher Signed: ..................................................(Please attach any further references) PLEASE NOTE ... Applicants may be required to appear in a preliminary performance on Sunday, 6th September, 2015 from 1.00 to 4.00 p.m. AND applicants selected MUST BE prepared to perform at the FINAL competition on Sunday 4 October 2015 at 1.00pm at Kings School Auditorium, Remuera Road, Auckland, where the final adjudication will take place. PLEASE NOTE ... Accompanists are not provided but if difficulties are experienced, please phone (09) 634-3988 urgently. Signature of parent or guardian of the applicant ................................................... Name of the parent or guardian ......................................................................... Date .................................... Phone: (home) (......)............................................ Have you entered this competition before? YES / NO (please circle one) Year ......... Dress Code: It is expected that performers will be dressed in formal clothes. That is, no jeans, casual clothes, sandals and the like. Further application forms can be obtained from, AND RETURNED to Music Competition PO Box 13512 Onehunga 1643 Auckland Phone: (09) 634 3988 or email to: ghrdej@xtra.co.nz APPLICATIONS CLOSE Monday, 17 August 2015 3NOTES. 1 2 3 4 5 6 Only the 2015 application form will be accepted. Earlier forms will be returned. The 2015 application form must be completed in FULL. That is, nothing left out. FOUR [4] copies of the 2015 application form must be sent in. THREE [3] photocopies of the music must be sent in with the 2015 application form. Each photocopy of the music must have the name of the composer and the name of the work at the top of the first page. Each application form must be checked by the performer’s Class Teacher or Music Teacher for completeness. CHECKLIST. 1 I am using the 2015 application form. [ ] 2 I have completed EVERY part of this form. [ ] 3 I have enclosed FOUR [4] copies of the form. [ ] 4 I have enclosed THREE [3] copies of the music. [ ] 5 The music has the name of the composer. [ ] 6 The music has the title/name of the work. [ ] 7 The class teacher has checked the form. [ ] 8 Proof of Citizenship [___] Signed __________________________ Parent/Guardian. Confirmation I have checked this performer’s application form and find that it has been completed both accurately (as far as I can tell) and in every detail. The parent understands how many copies of the form and music to include with their application. Signed _______________________ Class Teacher OR Music Teacher