JURY REPERTOIRE

To be completed by all students registered in Applied Principal Instrument, Elective Applied Study or Advanced Elective
Applied Study and submitted to your studio teacher for signature.

NAME_____________________________________________________________________________________

INSTRUMENT_______________________________________ COURSE NO._____________________________

DEGREE PROGRAM _______________________________________________________________________

List program prepared according to the DIVISIONAL JURY REQUIREMENTS for your instrument and course number.

COMPOSER TITLE TIMING

ORCHESTRAL EXCERPTS (where applicable)

_____________
Student’s Signature Date Studio Teacher’s Signature Date

Permission to substitute repertoire____________________________________________________________________

Studio Teacher’s Signature

STUDENTS, PLEASE NOTE: Your jury repertoire form must be submitted to your studio teacher for signing no later
than Nov. 15 for December juries and March 15 for April juries.
TEACHERS, PLEASE NOTE: Submit the signed form by Nov. 15 or Mar. 15, as applicable.

Western University Department of Music Performance Studies

Don Wright Faculty of Music rev 2020 10 29