Atterbury National Piano Competition

Application Form

Applicant Information

Surname

First Name ( as will appear in the competition program )

Name called by

RSA ID number ( must be a SA citizen or permanent resident)

Date of Birth (YYYY-MM-DD)

Age on 19 October 2020

School

Grade

Physical Address

Code

Postal Address

Code

Parent / Guardian

Title

Name

Surname

Cell No ( Parent / Guardian )

Email ( Parent/Guardian )

Cell No ( Candidate )

Telephone No ( Home )

Banking details for candidate

Name of account holder

Name of bank

Account No

Branch Code

Teacher

Title

Name

Surname

Cell No

Telephone No ( Work / Home )

Entry Fee

See payment details on the Home Page.

Proof of payment emailed to Marichen Kapp at m_kapp@netactive.co.za

Photograph

A black-and-white head-and-shoulders photograph of the entrant in JPEG format woih a DPI of not less than 300 must be emailed to Janet Becker at j.becker@saspine.co.za. This should be a good quality photograph as it will be printed in the program, and displayed on screens in the foyer of thetheatre during the competition. No photocopies or other photograph formats will be accepted.

Photograph has been sent by email.

Declaration by Parent / Guardian / Teacher

I declare that the abovementioned information is correct. My child agrees to follow the rules and regulations and to abideby the decisions of the adjudicators.I give permission that my child’s performances during the competition may be filmed or recorded for use by the organisers. No compensation will be paid.
I, the undersigned, will not hold the organisers and sponsors accountable for any loss,damage, injury or sickness that my child may suffer during the competition.

I agree with the above declaration.

Final Program Choice

Participant:

Age on 19 October 2020 (please state if candidate is participating in a different category than his /her age group )

In the COMPOSER block add (Initials and surname)
In the TITLE block add ( Name, key, opus number and movement/s )

1st Round

	Composer	Title	Duration
Baroque
Romantic

2nd Round

	Composer	Title	Duration
Classical
Modern/Impressionistic

3rd Round

	Composer	Title	Duration
One piece from 1st/2nd round
One new work

Any repertoire changes must be discussed with Claudine van Breda, in person, and submitted in writing to m_kapp@netactive.co.za( Marichen Kapp ). No changes to the repertoire will be allowed after 14 August 2020.

The following must reach us by 31 July 2020 ( NO LATE ENTRIES WILL BE ACCEPTED) :

The completed entry form sent by email to j.becker@saspine.co.za
Proof of payment sent by email to m_kapp@netactive.co.za
DVD via POSTNET (preferably ) to the Brooklyn Branch ( receiver Claudine van Breda, cell no 082 868 0301) or registered mail ( email tracking number and date sent to j.becker@saspine.co.za or sms to Janet Becker 083 450 7483
Photograph according to specifications sent by email to j.becker@saspine.co.za