Music Camp Application

Student Name
Parent Name
Address
City
State	ALAKAZCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMSMOMTNENVNHNJNMNCNDOHOKORPARISCSDTNTXUTVTVAWADCWVWIWY
Zip
Email
Home Phone
Work Phone
School
Grade
Age
Gender	MALE FEMALE
Instrument(s)
Years Studying
Music Teacher
Teacher Phone/ Email	If applying for financial aid please answer the following:
Total amount of financial aid requested
Adjusted gross income for 2008	(IRS Form 1040 Line 37, 1040A Line 21 or 1040EZ Line 5)
Exemptions claimed	(IRS Form 1040 Line 6d or Form 1040A Line 6d)

SEND CHECK FOR $130 ($100 Deposit and $30 Application Fee) to:
CLASSICOPIA - 33 Rayton Road, Hanover, NH 03755

www.classicopia.org ~~~ marcia@classicopia.org ~~~ daniel@classicopia.org

 

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