SUMMER PIANO CLINIC - Music Department - Utah State University

Utah State University
SUMMER PIANO CLINIC 2013
Application Form
Name:_____________________________________
Address:____________________________________
City:_________________State:____Zip:__________
Email:_____________________________________
Phone:_____________________Years Studied:_____
Parent or Guardian:___________________________
_______ Gender: qMale
qFemale Age:_______
PAYMENT:
q Early Discounted Tuition: $220
(Full payment must be postmarked June 15, 2013.)
q Normal Tuition: $240
q Application only: $30
(Non-refundable. Applied towards remaining balance,
which is due at registration July 15, 2013.)
$_____
Is on-campus housing required qYES qNO
q Housing/Meals/Activities: $210
q Meals/Activities only: $110
(Optional for students staying off-campus)
$_____
Private Lessons:
(30 minutes each, limited to 6 total lessons)
USU Clinic Faculty: $25 _____
Guest clinician: $40 ____
Professor Gary Amano: $60 _____
Total cost of lessons
Total Payment Enclosed:
No refunds given after July 3, 2013.
$_____
$_____
Please email Ldhancock@gmail.com with any questions/
concerns. Students will receive additional information once
application has been processed. Make checks payable to USU
Summer Piano Clinic. Mail Application form and payment to:
Luke Hancock
USU Music Department
4015 Old Main Hill
Logan UT 84322-4015
Music Department
4015 Old Main Hill
Logan UT 84322-4015
July 15-20, 2013
Chase Fine Arts Center
Logan, Utah