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Applicant
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| Full Name: |
| Age: |
Birth Date: |
SSN#: |
| Address: |
City: |
Zip: |
| Musical Specialty: |
Phone #: |
Applicant's address/phone while at school:
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| Accompanist (if needed): |
Phone #: |
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Education
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High school and college last attended, Give degrees and dates earned:
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Instrument or voice study, names of teachers and length of study with each:
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If applicant is a singer, list languages studied and length of study each:
I certify that I, (or my parents or legal guardian), have been a resident of San Diego county, Imperial County, or Baja California del Norte for the year preceding this audition. (Note: Residency requirement is not applicable to participants who have already passed the PRELIMINARY auditions).
Signature:_______________________
Mail this form to: Dr. Conrad Bruderer, P.O. Box 3475, La Mesa CA 91944-3475
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