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INSTRUCTIONS: Copy and paste this text into your word processor. Fill in name, address, and other required information using your word processor. You can delete instructions or unneeded information as necessary to make it fit on a page. Print out the completed form and submit.

Chords of Discovery

Missouri Music Teachers Association

Student Composition Competition

2005 Student Application Form

Application and Composition Postmarked Deadline: May 30, 2005

Send to Jennifer Linn, MMTA Composition Chair

Student Name_________________________________________________________

Address________________________________________________________

______________________________________________________________

Grade in school in the 2004-05 school year_________

Please indicate which category you are entering:

______Elementary K - 1 - 2 Kindergarten, first grade and second grade

______Elementary 3 - 4 Third grade and fourth grade

______Junior 5 - 6 Fifth grade and sixth grade

______Junior 7 - 8 Seventh grade and eighth grade

______Senior 9 - 10 Ninth grade and tenth grade

______Senior 11 - 12 Eleventh grade and twelfth grade

Title of composition______________________________________________________

Instrumentation___________________________________________________

Teacher Name____________________________________________________________

Address__________________________________________________________

Phone________________________________

Email_____________________________

MMTA Teacher Membership: Circle YES or NO

(Non MMTA members may enter students by paying an additional $15 teacher entry fee.)

ENTRY FEE $12 per elementary composition ____________

$16 per junior composition ____________

$20 per senior composition ____________

$15 Non MMTA teacher fee ____________

TOTAL ____________

Signature of the Student _______________________________Date____________

Signature of the Teacher_______________________________________

Date__________________________________

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