APPLICATION FORM (for all contestant)

of VII International Competition for Young Pianists

In Memory of Vladimir Horowitz

Surname and Name _________________________________________________________

Date of Birth_________________________________sex_______________________

Contestant’s Country__________________________________________________________

Place and Year of Studies; Class, Course____________________________________________

_____________________________________________________________________________

______________________________________________________________________________

Surname and Name of the Professor _______________________________________________

Awards at Competitions _________________________________________________________

__________________________________________________________________________ ___________________________________________________________________________

Home Address _______________________________________________________________

Phone/Fax/E-mail_______________________________________________________________

Accompanied by _____________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

I agree with the Terms of the Competition ____________________________________________

(personal signature of the contestant)

PROGRAM

Age Group: Senior, Intermediate, Junior (underline the appropriate word)

Qualification Round	Performance Duration of Each Piece
1^st Round	Performance Duration of Each Piece
2^nd Round	Performance Duration of Each Piece
3^rd Round	Performance Duration of Each Piece

PROGRAM

of the contestant of “Horowitz - Debut” Competition

Group: “A” Elementary, “B” Elementary, “C” Advanced, “D” Advanced

(Underline the appropriate words)

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________