150 Lake Dr, Ste 103
Wexford, PA 15090
724-934-PLAY (7529)
info@pycosom.com
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Online Chamber Music Seminar & Academy 2020
Monday, July 27th - Friday, July 31st
Fill out and submit an application below.
Click here to make a payment.
Click here for more information about the program.
Chamber Music Seminar Application
Register online by filling out the application form below. Please submit a separate form for each student that you are registering.
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Indicates required field
Student Name
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First
Last
Date of Birth
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Age
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Grade (2019-2020)
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Gender
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M
F
Prefer Not to Say
Instrument
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School That You Attend
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School District
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Student Email
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The student will be participating in:
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both the Seminar & Chamber Music Academy
the Seminar ONLY
the Chamber Music Academy ONLY
Ensembles in which you currently play, if applicable
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Parent Name
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First
Last
Primary Phone Number
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Secondary Phone Number
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Parent Email
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Private Teacher Name
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Private Teacher Email
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Private Teacher Phone Number
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Years of Study with Private Teacher
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School Music Teacher Name
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School Teacher Email
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School Teacher Phone Number
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I, the undersigned, as Parent/Guardian of the above named minor do hereby release the PYCO School of Music, its employees, and instructors, from any and all liability from any accidents which may occur. I also authorize the use of any photograph or video taken during the camp for publicity purposes.
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Please write any comments or questions below.
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