ASTA with NSOA Solo Competition
Pennsylvania/Delaware State Application Form


Please note: If you have Adobe Acrobat Reader, you may want to download the PDF version of this application.

First Name ____________________ Last Name _____________________

Address __________________________________________________________

City ____________________ State _________ Zip _______

Home Phone __________________________ E-mail _______________________

Birth date __________________
(Please provide proof of birthdate - birth certificate, driver's license, etc.)

Junior Division ____ Senior Division ____ Instrument ___________________

ASTA with NSOA membership number ____________
(Competitor or sponsoring teacher MUST be a member of ASTA with NSOA)

School ___________________________ Teacher _________________________

Signature ___________________________________________________________
By signing here, I certify that this information is accurate. ( For Junior Division Entrants, this form must also be signed by a parent or teacher)

Repertoire chosen for this competition:
___________________________________________________________________
___________________________________________________________________
(Please note - in order to be eligible to compete at the National Level, the chosen repertoire MUST include the required piece(s).)

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