LEH I

H G

VALLEY CH
TER AP

AS SO C.

Of The

Frank Chesebro Memorial Scholarship APPLICATION FORM

please complete using your computer

Applicants Name: Address: High School: College/Conservatory you pland to attend: Field of Study:
(Music Ed, Performance, etc.)

Main Instrument: Additional instrument/voice: Music Activities in School and Community:

Music Activities in LVC/PMTA:

Awards/Performances:
which piece you wish to use to start your audition.

Repertoire you will perform at Scholarship Audition:

Applicants Signature: Parent/Guardians Signature: Teachers Signature:

Three letters of recommendation, an essay, and repertoire list must be included with this application form. Mail or hand deliver to: Martha Schrempel, Chair, LVC-PMTA Scholarship 1133 N. 33rd Stre Allentown PA 18104-2675 NO LATE APPLICATIONS WILL BE ACCEPTED. Please nd the application deadline, audition date, time, and location posted on the LVC/PMTA website at www.lvpmta.org.

PA M

SI

CT RS E AC H E

Date: Date of Birth: Email: Phone:

COMPOSITION

Number of years studied: Number of years studied:

Please list the complete title including opus, K, BWV, Hob, etc. and check

COMPOSER

TIME

I attest that to the best of my knowledge the above information is accurate.

Date: Date: Date: